A patient recovering from a lobectomy has a chest tube attached to a water-seal drainage system. The healthcare provider notices the fluid in the water-seal column has stopped fluctuating. Which of the following would explain why the fluctuations have stopped?
Select all that apply:
- The lung has begun to collapse
- Positive interplueral pressure has increased
- The lung has fully expanded
- There may be fibrin clots in the tubing
- The drainage system has a leak in it
Answer: 3 and 5
The fluctuation in the water seal (tidaling) occurs as intrapleural pressure changes during inspiration and expiration. There should be patency between the intrapleural space and the chest tube system, so a blockage in the system may cause the tidaling to stop. Gradual reduction of the tidaling is expected as the lung re-expands, and will eventually stop when the lung has re-expanded.