DDPE-1
Research type
Research Study
Full title
Diaphragm Dynamics in Pleural Effusions 1 Study
IRAS ID
215842
Contact name
Cyrus Daneshvar
Contact email
Sponsor organisation
Plymouth Hospitals NHS Trust
Duration of Study in the UK
0 years, 8 months, 1 days
Research summary
Excessive fluid building up between the lining of the lungs (pleural effusion) occurs commonly, estimated to affect 3 in 1000 people. Systematic evaluation and intervention to relieve symptoms is often necessary and frequently leads to hospital admission. Whilst there are multiple causes, the large unilateral pleural effusion is most often due to an underlying cancer affecting the lining of the lung (pleura), with metastatic lung cancer accounting for 50-65% of patients with malignant pleural effusions.
Pleural effusions are associated with significant distressing symptoms that have an adverse effect on the patients’ quality of life. Patients often require many procedures to confirm a diagnosis, assess therapeutic benefit, followed by subsequent procedures to perform pleurodesis or insertion of an indwelling pleural catheter for long term symptom relief.
The volume of pleural fluid varies considerably at initial presentation between patients, and whilst difficult to measure in a complex 3D space, the total volume of pleural effusion does not necessarily correlate with symptoms. Not all patients experience symptom relief. Further removing large volumes of pleural fluid can incur complications at the procedural level and subsequently with the development of significant pain and life threatening re-expansion pulmonary oedema.
With the roll-out of thoracic ultrasound for pleural procedures, the presence of an inverted and paradoxically moving diaphragm is regularly seen. However its prevalence, effect on symptomology and dynamic change following pleural aspiration is unknown. This may provide a useful predictive diagnostics tool in symptom benefit and guide safe aspiration volumes in patients. This study aims to address some of these uncertainties.
REC name
Wales REC 7
REC reference
16/WA/0382
Date of REC Opinion
7 Dec 2016
REC opinion
Favourable Opinion