Fatal cerebral air embolism following chest drain removal for empyema: a rare but serious complication

Air embolism is a rare but potentially fatal complication of pleural drainage. We present a case of a late elderly man who developed a cerebral air embolism shortly after the removal of a chest drain inserted for empyema, in a setting without positive pressure ventilation. This resulted in a catastrophic neurological deterioration and death. The case highlights the importance of recognising air embolism as a differential in post-drain removal collapse, understanding its proposed mechanisms, and considering preventative measures. This report contributes to the limited literature on air embolism following chest drain removal and underscores the need for vigilance during all stages of pleural drainage management.