Recurrent fluid surrounding the lungs is associated with poor quality of life, the main symptom being dyspnea. These patients are in need of recurrent removal of the fluid using drainage. The mechanism causing dyspnea is not fully understood. By using ultrasound to evaluate the movement of the diaphragm before and after removal of fluid and the patients symptoms before removal of fluid and until next removal the research group aims to clarify the temporal development in symptoms and the role of the diaphragm. The researchers will also evaluate the ability of the pulmonologist and patient to predict when the patient will need the next removal of fluid in patients with recurrent unilateral pleural effusion.
Recurrent pleural effusion (PE) is associated with impaired quality of life, the main symptom being dyspnea. The mechanisms causing dyspnea in PE is not fully understood. These patients are in need of recurrent therapeutic thoracentesis. By evaluating the movement of diaphragma before and after thoracentesis and measure the patients symptoms before thoracentesis and until the next thoracentesis the researchers aim to clarify the temporal development in symptoms and the role of the diaphragm. The researchers will also evaluate the ability of the pulmonologist and patient to predict when the patient will need the next therapeutic thoracentesis in patients with recurrent unilateral pleural effusion.
Study Type
OBSERVATIONAL
Enrollment
107
Questionnaire is about symptoms measured by Edmonton Symptom Assessment Score (ESAS) and dyspnea also by modified Borg Scale (MBS)
Næstved Sygehus, department of pulmonary medicine
Næstved, Region Sjælland, Denmark
Zealand University Hospital, Roskilde
Roskilde, Region Sjælland, Denmark
Difference between time to next thoracentesis scheduled by the pulmonologist and patient respectively versus time to patient-reported need for thoracentesis
Measured in days. The patients and pulmonologists scheduling is recorded on a questionnaire at the day of first thoracentesis, after the procedure
Time frame: At the day of the next thoracentesis or 2 months after the first study-thoracentesis, whichever comes first.
Patients experienced well being
Symptoms measured by ESAS (Edmonton Symptom Assessment System, contains visual analogue scales measuring tiredness, pain, drowsiness, nausea, appetite, dyspnea, depression, anxiety, and general well being, scale 0-10, 0 being no symptoms, 10 being the worse symptoms)
Time frame: At day 1 immediately prior to and immediately after thoracentesis
Patients perception of dyspnea
Symptoms measured by MBS (Modified Borg Scale, scale1-5, 1 being no dyspnea, 5 being the worse dyspnea)
Time frame: At day 1 immediately prior to and immediately after thoracentesis.
Patients perception of dyspnea
Symptoms measured by MRC (Medical Research Council Dyspnoea Scale, scale1-5, 1 being the least dyspnea, 5 being the worse dyspnea)
Time frame: At day 1 immediately prior to and immediately after thoracentesis.
Patient experienced dyspnea until next thoracentesis
Measured in a daily diary completed at the same time slot every day by MBS (Modified Borg Scale, scale1-5, 1 being no dyspnea, 5 being the worse dyspnea)
Time frame: At the day of the next thoracentesis or 2 months after the first study-thoracentesis, whichever comes first.
Patient experienced dyspnea until next thoracentesis
Measured in a daily diary completed at the same time slot every day by Measured in a daily diary completed at the same time slot every day by MRC (Medical Research Council Dyspnoea Scale, scale1-5, 1 being the least dyspnea, 5 being the worse dyspnea)
Time frame: At the day of the next thoracentesis or 2 months after the first study-thoracentesis, whichever comes first.
Patient experienced well being until next thoracentesis
Measured in a daily diary completed at the same time slot every day by ESAS Symptoms measured by ESAS (Edmonton Symptom Assessment System, contains visual analogue scales measuring tiredness, pain, drowsiness, nausea, appetite, dyspnea, depression, anxiety, and general well being, scale 0-10, 0 being no symptoms, 10 being the worse symptoms)
Time frame: At the day of the next thoracentesis or 2 months after the first study-thoracentesis, whichever comes first.
Fluid removed at the first study-thoracentesis
measured in mL.
Time frame: At day 1, immediately after end of procedure
Fluid removed at the second study-thoracentesis
measured in mL.
Time frame: At the day of the the second thoracentesis, immediately after end procedure
Correlation between amount of pleural fluid removed at the first study-thoracentesis (outcome 6) and symptoms (well being and dyspnea, outcome 4 and 5) until next thoracentesis.
amount of fluid measured in mL.
Time frame: At the day of the next thoracentesis or 2 months after the first study-thoracentesis, whichever comes first.
Correlation between patient's symptoms (well being and dyspnea, outcome 4, 5and 6) and time to next thoracentesis
Time measured in days
Time frame: At the day of the next thoracentesis or 2 months after the first study-thoracentesis, whichever comes first.
Correlation between time in between thoracentesis and amount of fluid drained at the following thoracentesis
Time measured in days and amount of fluid measured in mL
Time frame: thoracentesis or 2 months after the first study-thoracentesis, whichever comes first.
Correlation between well being and dyspnea (outcome 2, 3 and 4) and findings on lung ultrasound before and after completed thoracentesis
Diaphragmatic movement (measured by M-mode and "The Area method", diaphragmatic shape (convex, flat, concave) and Septae-score)
Time frame: At day 1 immediately after ended procedure
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