title: Protocol of the PLeural Effusion And Symptom Evaluation (PLEASE) study on the pathophysiology of breathlessness in patients with symptomatic pleural effusions.
abstract: Pleural effusion is a common clinical problem that can complicate many medical conditions. Breathlessness is the most common symptom of pleural effusion of any cause and the most common reason for pleural drainage. However, improvement in breathlessness following drainage of an effusion is variable; some patients experience either no benefit or a worsening of their breathlessness. The physiological mechanisms underlying breathlessness in patients with a pleural effusion are unclear and likely to be multifactorial with patient-related and effusion-related factors contributing. A comprehensive study of the physiological and symptom responses to drainage of pleural effusions may provide a clearer understanding of these mechanisms, and may identify predictors of benefit from drainage. The ability to identify those patients whose breathlessness will (or will not) improve after pleural fluid drainage can help avoid unnecessary pleural drainage procedures, their associated morbidities and costs. The PLeural Effusion And Symptom Evaluation (PLEASE) study is a prospective study to comprehensively evaluate factors contributing to pleural effusion-related breathlessness.
  
  
  
  The PLEASE study is a single-centre prospective study of 150 patients with symptomatic pleural effusions that require therapeutic drainage. The study aims to identify key factors that underlie breathlessness in patients with pleural effusions and develop predictors of improvement in breathlessness following effusion drainage. Participants will undergo evaluation pre-effusion and post-effusion drainage to assess their level of breathlessness at rest and during exercise, respiratory and other physiological responses as well as respiratory muscle mechanics. Pre-drainage and post-drainage parameters will be collected and compared to identify the key factors and mechanisms that correlate with improvement in breathlessness.
  
  
  
  Approved by the Sir Charles Gairdner Group Human Research Ethics Committee (HREC number 2014-079). Registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616000820404). Results will be published in peer-reviewed journals and presented at scientific meetings.
  
  
  
  ACTRN12616000820404; Pre-results.
authors.affiliation: Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia Pleural Medicine Unit, Institute for Respiratory Health, Perth, Western Australia, Australia Centre for Respiratory Health, School of Medicine & Pharmacology, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Thomas
authors.affiliation: Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia Pleural Medicine Unit, Institute for Respiratory Health, Perth, Western Australia, Australia.
authors.forename: Maree
authors.initials: M
authors.lastname: Azzopardi
authors.affiliation: Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia Pleural Medicine Unit, Institute for Respiratory Health, Perth, Western Australia, Australia Centre for Respiratory Health, School of Medicine & Pharmacology, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Sanjeevan
authors.initials: S
authors.lastname: Muruganandan
authors.affiliation: Centre for Respiratory Health, School of Medicine & Pharmacology, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Read
authors.affiliation: Centre for Applied Statistics, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Kevin
authors.initials: K
authors.lastname: Murray
authors.affiliation: West Australian Sleep Disorders Research Institute, Perth, Western Australia, Australia Centre for Sleep Science, School of Anatomy, Physiology & Human Biology, University of Western Australia, Perth, Western Australia, Australia Pulmonary Physiology & Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Eastwood
authors.affiliation: Physiotherapy Unit, Institute for Respiratory Health, Perth, Western Australia, Australia Physiotherapy Department, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: Jenkins
authors.affiliation: West Australian Sleep Disorders Research Institute, Perth, Western Australia, Australia Centre for Sleep Science, School of Anatomy, Physiology & Human Biology, University of Western Australia, Perth, Western Australia, Australia Pulmonary Physiology & Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
authors.forename: Bhajan
authors.initials: B
authors.lastname: Singh
authors.affiliation: Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia Pleural Medicine Unit, Institute for Respiratory Health, Perth, Western Australia, Australia Centre for Respiratory Health, School of Medicine & Pharmacology, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Y C Gary
authors.initials: YC
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D004322:Drainage; D004417:Dyspnea / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000150:complications* / Q000601:surgery*; D011446:Prospective Studies; D012107:Research Design; D015656:Respiratory Mechanics; D063189:Symptom Assessment; D055815:Young Adult
keywords: Breathlessness; Diaphragm; Dyspnoea; Effusion; Pleura