I don't clamp the chest tube before its removal. I think it is not necessary to do that, however, we have to talk with our patients before remove it about a little bit pain at the chest tube inserted site and don't be scare.  Patient must hold the deep inspiratory breath during remove that.

Thanks Dr Apichat.

The debate exist in my institution as well! 

I choose never to clamp the chest tube, as well as I can cooperate with the patient and remove the tube with one quick move during patient's maximum inhalation. I never experienced any complication (i.e. iatrogenic pneumothorax) with this method.

Ofcourse I agree with Dr Tantaworasin, we have to inform the patient in detail about the procedure and the pain.

THANKS DR KONSTANTINA

We don't clamp the chest tube before its removal.  Regarding clamping the chest tube for several hours and taking a cxr before removal of the tube; I have to say that this is forbbiden in my unit and many others centers as this could produce an inadvertent tension pneumothorax.

DR fafael

thanks for ur answer, however somebody will tell u that it is developing an inadvertent tension pneumothorax with clamped chest tube is better than its ocurrence after chest tube removal. U can just remove the clamp instead of reinserting a new chest tube.

So i may consider that once u decided to clamp the tube is the time to remove

If we inserted the tube for pneumothorax either spontaneous or iatrogenic or post resection , I'd prefer to clamp it before removal. This may prevent  other tube insertion.

in case of other indications no need to clamp. I usually remove the tube on suction after giving the patient good analgesia.

DEAR MOHAMMED

THANKS.  I DO THINK THAT CLAMPING THE CHEST TUBE  some HOURS(more than 1 hour)  BEFORE REMOVAL IS JUST A WASTE OF TIME. CLAMPING THE TUBE Means that it is ready to remove. IF SOMEBODY CLAMPED A CHEST TUBE AND THE LUNG COLLAPSED, this means that it was not ready for removal. I MAY CLAMP it foe an hour or so and repeat the chest x ray, explain and communicate with the patient and nurses about the possibility of dyspnoea  and desaturation or chest pain. 

I remove the tube with one quick move during patient's maximum exspiration (!) after x-ray control with clamped tube.

I also don't clamp the chest tube before its removal. Some times I make test with clamping and after radiographic control remove the drainage without clamping.

I routinely do not clamp before removal. However if the pt has subcutaneous emphysema and had a longer period of air leak than usual (3-4 days), or if there is a high ossicilation in the tube I clamp. 

THANKS A LOT Dr Lacin