Question

An adult male patient who is receiving volume-controlled ventilation has a chest tube drainage system in place with a chest tube in the right anterior lung. Suction pressure at the wall is set to 120 mmHg. The therapist notices profuse bubbling in the water seal chamber. The low volume alarm is sounding and the digital display on the ventilator indicates a return volume of 220 mL. Which of the following clinical conditions should the respiratory therapist suspect?

1) leak in the tubing between the fluid collection and water seal chambers
2) leak in the tubing between the patient and the fluid collection chamber
3) perforation in the lung tissue
4) leak in the ventilator circuit

Answer 1

The respiratory therapist should suspect a leak in the tubing between the patient and the fluid collection chamber.

Step-by-step explanation:

The respiratory therapist should suspect that the leak in the tubing between the patient and the fluid collection chamber is causing the profuse bubbling in the water seal chamber and the low volume alarm.

The return volume of 220 mL indicates that there is not enough air going into the lung, which can be caused by a leak in the tubing connecting the patient to the fluid collection chamber.

This leak could be preventing the appropriate amount of pressure from reaching the lung and causing the chest tube drainage system to malfunction.