Abstract
Background: Pleural effusion drainage is generally successful in reducing dyspnoea in patients with symptomatic malignant pleural effusion (MPE). There is paucity of data on whether abnormal diaphragm function/geometry pre-drainage predicts symptomatic outcome.
Methods: In a study of physical activity levels in the peri-drainage period in MPE patients, diaphragm US (shape, direction of movement, tidal excursion) and 100 mm VAS score for dyspnoea were completed immediately before therapeutic drainage and repeated within 1hr – 7days of procedure.
Results: The study recruited 20 patients (median age 70 years), but US data was available for 14. Median VAS score before intervention was 44 (22-79) mm. Median step count/day was 1671 (175 – 3350) steps and this was negatively correlated with baseline VAS (R -0.603, p 0.008). Diaphragm shape/direction was abnormal in 8/14 patients. Median volume drained was 1200 ml and in 14/14 patients the diaphragm shape/direction was normal post drainage. 8/14 patients had significant improvement in VAS; 3 of which had initial abnormal diaphragm examination, while 3/6 with normal pre and post draiange diaphragm examination had VAS improvement (chi2, p 0.639). Data for diaphragm excursion was available for 7 patients. There was a trend towards positive correlation between the absolute improvement in diaphragm excursion and in VAS score post drainage (R 0.454, p 0.306)
Conclusion: Dyspnoea due to MPE is associated with reduced physical activity. US shape/direction did not predict symptomatic response to fluid drainage, but diaphragm excursion may be able to predict response. These results need to be validated in a larger cohorts of patients.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 2787.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020