{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:35:07Z","timestamp":1791581707159,"version":"4.3.4"},"reference-count":42,"publisher":"European Respiratory Society (ERS)","issue":"5","license":[{"start":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T00:00:00Z","timestamp":1582156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.ersjournals.com\/user-licence"}],"funder":[{"DOI":"10.13039\/501100001170","name":"Cancer Council Western Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001170","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Sir Charles Gairdner Research Advisory Group"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2020,2,5]]},"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pathophysiology changes associated with pleural effusion, its drainage and factors governing symptom response are poorly understood. Our objective was to determine: 1) the effect of pleural effusion (and its drainage) on cardiorespiratory, functional and diaphragmatic parameters; and 2) the proportion as well as characteristics of patients with breathlessness relief post-drainage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospectively enrolled patients with symptomatic pleural effusions were assessed at both pre-therapeutic drainage and at 24\u201336\u2005h post-therapeutic drainage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      145 participants completed pre-drainage and post-drainage tests; 93% had effusions \u226525% of hemithorax. The median volume drained was 1.68\u2005L. Breathlessness scores improved post-drainage (mean visual analogue scale (VAS) score by 28.0\u00b124\u2005mm; dyspnoea-12 (D12) score by 10.5\u00b18.8; resting Borg score before 6-min walk test (6-MWT) by 0.6\u00b11.7; all p&lt;0.0001). The 6-min walk distance (6-MWD) increased by 29.7\u00b173.5\u2005m, p&lt;0.0001. Improvements in vital signs and spirometry were modest (forced expiratory volume in 1\u2005s (FEV\n                      <jats:sub>1<\/jats:sub>\n                      ) by 0.22\u2005L, 95% CI 0.18\u20130.27; forced vital capacity (FVC) by 0.30\u2005L, 95% CI 0.24\u20130.37). The ipsilateral hemi-diaphragm was flattened\/everted in 50% of participants pre-drainage and 48% of participants exhibited paradoxical or no diaphragmatic movement. Post-drainage, hemi-diaphragm shape and movement were normal in 94% and 73% of participants, respectively. Drainage provided meaningful breathlessness relief (VAS score improved \u226514\u2005mm) in 73% of participants irrespective of whether the lung expanded (mean difference 0.14, 95% CI 10.02\u20130.29; p=0.13). Multivariate analyses found that breathlessness relief was associated with significant breathlessness pre-drainage (odds ratio (OR) 5.83 per standard deviation (\n                      <jats:sc>sd<\/jats:sc>\n                      ) decrease), baseline abnormal\/paralyzed\/paradoxical diaphragm movement (OR 4.37), benign aetiology (OR 3.39), higher pleural pH (OR per\n                      <jats:sc>sd<\/jats:sc>\n                      increase 1.92) and higher serum albumin level (OR per\n                      <jats:sc>sd<\/jats:sc>\n                      increase 1.73).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Breathlessness and exercise tolerance improved in most patients with only a small mean improvement in spirometry and no change in oxygenation. Breathlessness improvement was similar in participants with and without trapped lung. Abnormal hemi-diaphragm shape and movement were independently associated with relief of breathlessness post-drainage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/13993003.00980-2019","type":"journal-article","created":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T13:35:16Z","timestamp":1582205716000},"page":"1900980","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":81,"title":["The Pleural Effusion And Symptom Evaluation (PLEASE) study of breathlessness in patients with a symptomatic pleural effusion"],"prefix":"10.1183","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0943-4297","authenticated-orcid":false,"given":"Sanjeevan","family":"Muruganandan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maree","family":"Azzopardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deirdre B.","family":"Fitzgerald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi Jin","family":"Kuok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui Min","family":"Cheah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine A.","family":"Read","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charley A.","family":"Budgeon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4490-4138","authenticated-orcid":false,"given":"Peter R.","family":"Eastwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Jenkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhajan","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Murray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.C. Gary","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2020,2,20]]},"reference":[{"key":"2024102101223536000_55.5.1900980.1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.104.5.1486"},{"key":"2024102101223536000_55.5.1900980.2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.136994"},{"key":"2024102101223536000_55.5.1900980.3","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-1679"},{"key":"2024102101223536000_55.5.1900980.4","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(83)91072-0"},{"key":"2024102101223536000_55.5.1900980.5","doi-asserted-by":"publisher","DOI":"10.1378\/chest.107.6.1610"},{"key":"2024102101223536000_55.5.1900980.6","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.156.4.9612113"},{"key":"2024102101223536000_55.5.1900980.7","doi-asserted-by":"publisher","DOI":"10.1186\/cc10009"},{"key":"2024102101223536000_55.5.1900980.8","doi-asserted-by":"publisher","DOI":"10.1136\/thx.38.10.747"},{"key":"2024102101223536000_55.5.1900980.9","doi-asserted-by":"publisher","DOI":"10.1378\/chest.74.5.540"},{"key":"2024102101223536000_55.5.1900980.10","doi-asserted-by":"publisher","DOI":"10.1378\/chest.130.5.1354"},{"key":"2024102101223536000_55.5.1900980.11","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201404-152OC"},{"key":"2024102101223536000_55.5.1900980.12","doi-asserted-by":"publisher","DOI":"10.1172\/JCI101498"},{"key":"2024102101223536000_55.5.1900980.13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2007.01124.x"},{"key":"2024102101223536000_55.5.1900980.14","first-page":"341","article-title":"Changes in pulmonary function following therapeutic thoracocentesis (abstract)","volume":"80","author":"Light","year":"1981","journal-title":"Chest"},{"key":"2024102101223536000_55.5.1900980.15","doi-asserted-by":"crossref","first-page":"510","DOI":"10.2214\/ajr.164.2.7840008","article-title":"Pleural effusions, diaphragm inversion, and paradox: new observations using sonography","volume":"164","author":"Cooper","year":"1995","journal-title":"AJR Am J Roentgenol"},{"key":"2024102101223536000_55.5.1900980.16","doi-asserted-by":"publisher","DOI":"10.1148\/84.6.1080"},{"key":"2024102101223536000_55.5.1900980.17","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0000000000000174"},{"key":"2024102101223536000_55.5.1900980.18","doi-asserted-by":"crossref","first-page":"e0202621","DOI":"10.1371\/journal.pone.0202621","article-title":"In patients with unilateral pleural effusion, restricted lung inflation is the principal predictor of increased dyspnoea","volume":"13","author":"Garske","year":"2018","journal-title":"PLoS One"},{"key":"2024102101223536000_55.5.1900980.19","doi-asserted-by":"crossref","first-page":"e0123798","DOI":"10.1371\/journal.pone.0123798","article-title":"Defining the minimal important difference for the visual analogue scale assessing dyspnea in patients with malignant pleural effusions","volume":"10","author":"Mishra","year":"2015","journal-title":"PLoS One"},{"key":"2024102101223536000_55.5.1900980.20","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-013213"},{"key":"2024102101223536000_55.5.1900980.21","doi-asserted-by":"publisher","DOI":"10.1081\/COPD-200050655"},{"key":"2024102101223536000_55.5.1900980.22","doi-asserted-by":"publisher","DOI":"10.3109\/02770903.2011.585412"},{"key":"2024102101223536000_55.5.1900980.23","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0693"},{"key":"2024102101223536000_55.5.1900980.24","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.118521"},{"key":"2024102101223536000_55.5.1900980.25","doi-asserted-by":"publisher","DOI":"10.1249\/00005768-198205000-00012"},{"key":"2024102101223536000_55.5.1900980.26","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.5535"},{"key":"2024102101223536000_55.5.1900980.27","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1001\/jama.2017.17426","article-title":"Effect of an indwelling pleural catheter vs talc pleurodesis on hospitalization days in patients with malignant pleural effusion: the AMPLE randomized clinical trial","volume":"318","author":"Thomas","year":"2017","journal-title":"JAMA"},{"key":"2024102101223536000_55.5.1900980.28","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/S2213-2600(18)30288-1","article-title":"Aggressive versus symptom-guided drainage of malignant pleural effusion via indwelling pleural catheters (AMPLE-2): an open-label randomised trial","volume":"6","author":"Muruganandan","year":"2018","journal-title":"Lancet Respir Med"},{"key":"2024102101223536000_55.5.1900980.29","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2016-000171"},{"key":"2024102101223536000_55.5.1900980.30","doi-asserted-by":"publisher","DOI":"10.1177\/1474515113514891"},{"key":"2024102101223536000_55.5.1900980.31","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00150314"},{"key":"2024102101223536000_55.5.1900980.32","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00034505"},{"key":"2024102101223536000_55.5.1900980.33","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-130-11-199906010-00004"},{"key":"2024102101223536000_55.5.1900980.34","doi-asserted-by":"publisher","DOI":"10.1378\/chest.90.6.852"},{"key":"2024102101223536000_55.5.1900980.35","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1979.03300100038019"},{"key":"2024102101223536000_55.5.1900980.36","doi-asserted-by":"publisher","DOI":"10.1159\/000193932"},{"key":"2024102101223536000_55.5.1900980.37","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1979.03300100038019"},{"key":"2024102101223536000_55.5.1900980.38","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(98)70250-8"},{"key":"2024102101223536000_55.5.1900980.39","unstructured":"R: a language and environment for statistical computing. Vienna, R Foundation for Statistical Computing, 2017. www.r-project.org\/ Date last accessed: 2 April 2020."},{"key":"2024102101223536000_55.5.1900980.40","doi-asserted-by":"publisher","DOI":"10.1111\/jep.12629"},{"key":"2024102101223536000_55.5.1900980.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2009.10.017"},{"key":"2024102101223536000_55.5.1900980.42","doi-asserted-by":"publisher","DOI":"10.1177\/1479972315603715"}],"container-title":["European Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/13993003.00980-2019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T02:29:09Z","timestamp":1740364149000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/13993003.00980-2019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,20]]},"references-count":42,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,5,14]]},"published-print":{"date-parts":[[2020,5]]}},"alternative-id":["10.1183\/13993003.00980-2019"],"URL":"https:\/\/doi.org\/10.1183\/13993003.00980-2019","relation":{},"ISSN":["0903-1936","1399-3003"],"issn-type":[{"value":"0903-1936","type":"print"},{"value":"1399-3003","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,20]]}}}