Affiliation:
1. Pleural Medicine Unit Institute for Respiratory Health Perth Western Australia Australia
2. Exercise Medicine Research Institute, School of Medical and Health Sciences Edith Cowan University Perth Western Australia Australia
3. Department of Respiratory and Sleep Medicine Westmead Hospital Sydney New South Wales Australia
4. Department of Respiratory Medicine Sir Charles Gairdner Hospital Perth Western Australia Australia
5. School of Medicine University of Western Australia Perth Western Australia Australia
Abstract
AbstractBackgroundPleural effusions often cause disabling breathlessness, however the mechanism is unknown. Patients with pleural effusions are subjected to pleural fluid drainage on a ‘trial and error’ basis, as symptom relief varies. This population commonly complain of bendopnoea (breathlessness on bending forward) which has not been investigated. Our pilot data found bendopnoea was significantly associated with presence of pleural effusion. The PLEASE‐3 study will evaluate bendopnoea as a screening test for effusion‐related breathlessness, its predictive value of symptomatic benefits from fluid drainage and explore its underlying physiological mechanism.MethodsPLEASE‐3 is a multi‐centre prospective study. Eligible patients are assessed at baseline (pre‐drainage) and for patients undergoing drainage, up to 72 h post‐procedure. Outcome measures include the prevalence of bendopnoea, its correlation with size of effusion and its predictive value of breathlessness relief after drainage. The relationship of bendopnoea with breathlessness, physiological parameters, functional capacity and diaphragmatic characteristics will be assessed. The study will recruit 200 participants.DiscussionThis is the first study to investigate bendopnoea in patients with pleural effusion. It has minimal exclusion criteria to ensure that the results are generalisable. The presence and clinical significance of bendopnoea in the context of pleural effusion requires thorough investigation. The post assessment of patients undergoing pleural fluid drainage will provide insight into whether the presence of bendopnoea is able to predict clinical outcomes.Trial RegistrationName of the registry: Australia New Zealand Clinical Trial RegistryTrial registration number: ACTRN12622000465752.URL of the trial registry record for this trial: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=383639&isReview=trueDate of registration: Registered on 24 March 2022.Funding of the trial: This study has received funding from the Sir Charles Gairdner Research Advisory Council research project grant. The study is sponsored by the Institute for Respiratory Health, a not‐for‐profit organisation.Name and contact information for the trial sponsor: Mr Bi Lam; Finance manager. Level 2, 6 Verdun Street, Nedlands WA 6009. t‖ + 61 8 6151 0877 e‖ bi.lam@resphealth.uwa.edu.auRole of sponsor: The funder is not involved in the planning of the study, gathering, analysing, and interpreting the data, or in preparing the manuscript.