(Also known as USG-guided chest tube insertion or thoracostomy)
USG-guided Intercostal Drain (ICD) insertion is a safe and effective bedside procedure for draining pleural collections such as pleural effusion, empyema, hemothorax, or pneumothorax. Real-time ultrasound guidance improves accuracy, reduces complications, and is especially beneficial in loculated collections or critically ill patients.
Pleural effusion (free-flowing or loculated)
Empyema
Hemothorax
Pneumothorax (if under tension or large)
Post-surgical fluid collection
Malignant pleural effusions
Accurate localization of fluid
Avoids injury to lung, diaphragm, or abdominal organs
Ideal for small, loculated, or posterior collections
Safer in patients with adhesions or previous thoracic surgeries
Ultrasound guidance significantly increases safety and accuracy, especially in loculated effusions.
Use Seldinger technique for controlled, minimally traumatic insertion.
Always aspirate before dilating to confirm pleural access.
Ensure side holes of the tube are within the pleural space to avoid subcutaneous placement.