How many chest tubes are required for a unilateral pneumohemothorax and where are they located?

For a unilateral pneumohemothorax, the requirement for two chest tubes—one placed apically and one at a basal location—ensures optimal drainage of both air (pneumothorax) and blood (hemothorax) from the pleural space. The apical tube is positioned higher to effectively remove the air that tends to rise to the top of the pleural cavity, while the basal tube targets the lower region where blood accumulates due to gravity.

This dual approach is essential because while one chest tube might adequately drain one component, it may not effectively manage both air and fluid accumulation. Therefore, the placement of an apical chest tube for air removal and a basal chest tube for fluid drainage is best practice in managing a unilateral pneumohemothorax.