Fig. 24From: Demystifying the persistent pneumothorax: role of imagingWater seal drainage system. Bubbling within the air leak chamber (*) should cease within 24Â h. If an air leak has already sealed, bubbling will be seen only with cough or Valsalva. Continuous bubbling indicates a large air leak. A cardinal sign of a blocked thoracic tube is failure of the fluid column within the tube to fluctuate with coughing or respirationBack to article page