The aim of this study is to better understand the relationship between pleural effusions and breathlessness in patients with unilateral pleural effusions and breathlessness who require pleural fluid removal for its management.
This study will involve 124 adult patients who are breathlessness with pleural effusions. They will be recruited from a single UK centre over an 18-month period. After being informed about the study, all patients giving written informed consent will undergo a baseline assessment when they first come to have their fluid drained. The investigators will record information about them and their disease. The investigators will take measurements of their breathlessness, their breathing muscles, and the electrical activity from the brain to those muscles. These will be taken at the start and end of drainage, as well as 1 day and 7 days after. The investigators will use this information to look for links between the effect of pleural effusions and its removal on the electrical activities of the breathing muscles and patients' breathlessness.
Study Type
OBSERVATIONAL
Enrollment
124
The surface parasternal EMG of participants will be measured pre, immediately post and at days 1 and 7 following pleural fluid removal
The ipsilateral and contralateral surface diaphragm EMG of participants will be measured pre and immediately post pleural fluid removal
The thickness of the parasternal intercostal muscle of participants will be measured using thoracic ultrasound pre and immediately post pleural fluid removal
Guy's & St Thomas' NHS Foundation Trust
London, United Kingdom
RECRUITINGNeural respiratory drive (as measured by surface parasternal EMG) at 24 hours post pleural fluid removal
Neural respiratory drive index (as measured by surface parasternal EMG)
Time frame: 24 hours
Patient reported breathlessness (as measured by VAS dyspnoea score) at 24 hours post pleural fluid removal
VAS dyspnoea score
Time frame: 24 hours
Neural respiratory drive (as measured by surface parasternal EMG) at other time points post pleural fluid removal
Neural respiratory drive index (as measured by surface parasternal EMG)
Time frame: pre procedure, immediately post procedure and daily up to 7 days
Patient reported breathlessness (as measured by VAS dyspnoea score) at other time points post pleural fluid removal
VAS dyspnoea score
Time frame: pre procedure, immediately post procedure and daily up to and 7 days
The effect on exercise capacity of pleural fluid removal.
6 min walk test
Time frame: pre procedure, immediately post procedure, 1 day and 7 days
Pleural effusion characteristics as measured by thoracic ultrasound
Thoracic ultrasound
Time frame: immediately post procedure, 1 day and 7 days
To determine the acceptability of incorporating surface parasternal EMG measurement as part of routine clinical practice to patients and clinicians
Qualitative feedback form
Time frame: peri-procedural
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The VAS breathlessness score and Dyspnoea-12 questionnaire of participants will be measured pre, immediately post and at days 1 and 7 following pleural fluid removal
Neural respiratory drive (as measured by surface diaphragm EMG) of the ipsilateral hemidiaphragm following thoracocentesis
Neural respiratory drive index (as measured by surface diaphragm EMG)
Time frame: peri-procedural
Ipsilateral hemidiaphragm morphology and movement as measured by thoracic ultrasound.
Thoracic ultrasound
Time frame: peri-procedural
Neural respiratory drive (as measured by surface diaphragm EMG) of the contralateral hemidiaphragm following thoracocentesis
Neural respiratory drive index (as measured by surface diaphragm EMG)
Time frame: peri-procedural
Contralateral hemidiaphragm morphology and movement as measured by thoracic ultrasound.
Thoracic ultrasound
Time frame: peri-procedural
Parasternal intercostal muscle thickness as measured by thoracic ultrasound following pleural fluid removal
Thoracic ultrasound
Time frame: peri-procedural