What does constant bubbling in the water-seal column of a chest drainage system indicate?

Constant bubbling in the water-seal column of a chest drainage system is indicative of a possible air leak. In a properly functioning chest drainage system, intermittent bubbling may be observed if there is air being removed from the pleural space as the lung re-expands. However, constant bubbling suggests that there is persistent airflow entering the drainage system, which is not normal.

This constant flow of bubbles indicates that air is escaping from somewhere, potentially due to a leak in the chest tube, the connection at the insertion site, or in the drainage system itself. In such cases, it is essential to assess the entire system to locate and address the source of the leak, as this can affect the effectiveness of treatment for conditions such as pneumothorax or pleural effusion.