National Patient Safety Alert: Deterioration due to rapid offload of pleural effusion fluid from chest drains

Alert warns that if large volumes of pleural fluid are drained too quickly from chest drains, patients can rapidly deteriorate from the potentially life-threatening complication of re-expansion pulmonary oedema.

SPS commentary:

Alert also advises that the rate at which fluid is drained must be controlled in order to prevent cardiovascular instability and collapse. Henceforth, providers are asked to review local chest drain clinical procedures to ensure they follow national guidelines and standards; and to ensure clear instruction on frequency of observation, red flag triggers and local escalation procedures for patient deterioration are available at the patient’s bedside.


Medicines and Healthcare products Regulatory Agency