Clamping may be appropriate to prevent discomfort and reduce risk of oedema

Editor—Jonathan Hyde and colleagues' description of the insertion of chest drains was both clear and helpful.1 The authors state, however, that there is no definite indication for clamping a chest drain.

In our oncology practice most drains are inserted to drain pleural effusions. Large pleural effusions drain rapidly, and most patients experience considerable discomfort, with chest tightness and coughing. In addition, removing a large collection of either air or fluid from the pleural cavity carries a recognised risk of inducing pulmonary oedema, which has been reported as occasionally fatal.2 3 4 The …