Trajectory of dyspnoea in patients with unilateral pleural effusion following thoracentesis.

Abstract

<b>Introduction:</b> In patients with pleural effusion, maximal relief of dyspnoea is perceived to occur in the days after therapeutic thoracentesis. Intuitively, re-accumulation of pleural fluid should lead to a steady increase in dyspnoea. This study aimed to visualize the trajectories of patient-perceived dyspnoea between therapeutic thoracenteses in patients with recurrent unilateral pleural effusion (UPE). <b>Methods:</b> In a prospective observational study, patients with UPE in need of therapeutic thoracentesis registered their resting level of dyspnoea using the modified Borg scale (MBS) from index thoracentesis and daily at same timeslot until next thoracentesis, max. 60 days. Clinically important decrease (CID) in MBS on day 1: MBS descrease ≥1 compared to pre-thoracentesis score. <b>Results:</b> Daily diaries were completed by 49 patients. Mean volume drained at inclusion was 1421ml (SD 701). Thirty-two patients had a CID in MBS day 1 after thoracentesis. Fourty-two patients had a re-thoracentesis within 60 days (median days: 13 (range 3-60)). Mean volume drained at re-thoracentesis was 1362ml (SD 779), daily production rate being 128 ml/day (SD 109). The level of dyspnoea did not follow a curved trajectory; Figure 1 depicts the considerable individual variation. Patient 43-49 had no re-thoracentesis. &nbsp; <b>Conclusions:</b> In this series, patient-reported dyspnoea using MBS was not evidently correlated with re-accumulation of pleural fluid.