Using ultrasound to predict the results of draining pleural effusions
Research type
Research Study
Full title
Correlation of pleural manometry with real-time thoracic ultrasound, symptomatic benefit and clinical outcome in patients with pleural effusion: a pilot study
IRAS ID
138016
Contact name
Najib M Rahman
Contact email
Sponsor organisation
University of Oxford
Research summary
The term “pleural effusion” describes an abnormal fluid collection around the lungs that can cause symptoms including chest discomfort, cough, fever and most commonly breathlessness. Ordinarily the lungs have a thin layer of fluid around them to provide lubrication against the chest wall whilst breathing. However, in a number of conditions the volume of fluid can become excessive; either from overproduction (e.g. in infection or cancer) or leakage (e.g. in heart or kidney failure) of fluid into the pleural space. This problem is extremely common; annually 1.5 million patients are diagnosed with a pleural effusion in the United States alone.
Standard care in managing a pleural effusion includes sampling the fluid, a process called thoracocentesis, using a needle and/or flexible plastic tube inserted into the chest with ultrasound guidance. This is both diagnostic (to determine the cause) and therapeutic (to relieve symptoms). However, it is not always straightforward to tell why some patients’ symptoms are more severe for a given size of pleural effusion; how much fluid should be removed to provide relief; whether a patient’s lung will fully re-inflate when fluid is removed; and why some patients with effusions fail standard treatment (pleurodesis) aimed at stopping the fluid from recurring.
Our study aims to correlate chest ultrasound findings before, during and after thoracocentesis with the volume of pleural fluid removed and changes in pleural pressure to determine if we can predict clinical outcome. Neither the use of ultrasound, nor that of a manometer to measure pleural pressure pose any additional risk to the patient; and may ultimately allow clinicians to make better decisions on future management, reducing cost to both the patient and NHS by minimizing hospital visits and length of stay.
REC name
East Midlands - Derby Research Ethics Committee
REC reference
13/EM/0381
Date of REC Opinion
14 Oct 2013
REC opinion
Further Information Favourable Opinion