Intercostal Catheter Insertion

Evidence 

https://www.ncbi.nlm.nih.gov/books/NBK604214/ 

Emily J. Zolfaghari; Madonna Lee. 

Chest tube placement, or thoracostomy, is a critical procedure performed to drain air, fluid, or pus from the pleural space. Chest tubes and pigtail catheters have become increasingly important in treating paediatric pleural space diseases. Chest tube indications in the neonate are similar to those in adults. However, the anatomical differences between these populations make neonatal thoracostomy tube placement challenging to the untrained provider. Successful performance of this procedure involves careful preparation, precise execution, and vigilant post procedure monitoring to ensure optimal outcomes for these vulnerable patients. 

Education 

An intercostal catheter (ICC) insertion (also called a chest drain) is a small, flexible tube that is inserted between the ribs into the space around your baby’s lungs (called the pleural space). It helps to remove air, fluid or infection making it easier for your baby to breathe. 

This is a common procedure in the neonatal unit and is used when a baby has: 

• A collapsed lung (pneumothorax) 

• A build-up of fluid around the lungs (pleural effusion) 

• An infection such as empyema  

• Bleeding into the chest area after surgery  

Some premature and sick newborns develop lung problems that make it hard for them to breathe on their own. If air or fluid collects in the chest and pushes on the lungs, it can stop them from working properly. An intercostal drain helps by: 

• Allowing the lungs to expand fully 

• Reducing pressure in the chest 

• Helping your baby breathe more easily 

Empowerment  

Seeing your baby with tubes and medical equipment can be upsetting. But remember, this procedure is done to support your baby’s breathing and recovery. 

You can still: 

• Talk and sing to your baby – your voice is comforting. 

• Touch and hold your baby gently, as guided by the healthcare team. 

• Be involved in nappy changes, washes and cuddle times when your baby is stable. 

Ask your care team: 

• Why your baby needs the drain 

• How long it might stay in 

• How does the healthcare team monitor for signs of any pain or discomfort  

• What signs they’re looking for to know your baby is improving 

Useful Links 

Liverpool Women’s Hospital UK 

https://www.liverpoolwomens.nhs.uk/media/3741/leaflet-why-does-my-baby-need-a-chest-drain.pdf 

Panda - Perinatal Mental Health   

https://panda.org.au/   

COPE – Centre of Perinatal Excellence   

http://www.cope.org.au/new-parents/first-weeks/coping-following-a-premature-birth/  

For When – Perinatal Mental Health and Wellbeing  

https://forwhenhelpline.org.au/