11th January 2024

A 65-year-old gentleman is on the respiratory ward for drainage of a massive pleural effusion secondary to metastatic prostate cancer.

A 65-year-old gentleman is on the respiratory ward for drainage of a massive pleural effusion secondary to metastatic prostate cancer. The drain was inserted without complication by the respiratory team 1-hour ago. Unfortunately, the patient has significantly deteriorated in the past 10 minutes with cough, tachypnoea and hypoxia. The drain remains in situ and continues to drain pleural fluid. His current observations are respiratory rate 36 breaths/ minute, oxygen saturations 91% on 15L via non-rebreather device, HR 130bpm and blood pressure 140/100mmHg. 

What is the most likely explanation of these clinical findings? 

Select the SINGLE most appropriate option from the list below. Select ONE option only.