Body Positioning for Dyspnea in Patients with Cancer with Unilateral Pleural Effusion: A Pilot Trial.

BACKGROUND

Dyspnea is common in advanced cancer, especially with unilateral pleural effusion. Lateral positioning is widely used, but evidence of effectiveness is limited.

OBJECTIVES

To assess the feasibility and short-term effects of affected-side-down (PLEUR-DOWN) versus affected-side-up (PLEUR-UP) positioning for dyspnea relief.

DESIGN

Multicenter randomized crossover pilot trial.

SETTING/SUBJECTS: Ten patients with cancer with dyspnea were enrolled at seven hospitals in Japan.

METHODS

Patients (numerical rating scale [NRS] ≥ 3) were randomized to two sequences. Each position was maintained for five minutes within a washout period. The primary outcome was feasibility, assessed by completion, absence of carryover/period effects, and adherence. Secondary outcomes included NRS changes, patient preference, and safety.

RESULTS

All patients completed the trial. No significant carryover (p = 0.57) or period effects (p = 0.25) were found. Mean NRS difference favored PLEUR-DOWN (-0.9; p = 0.34). Half preferred PLEUR-DOWN. No adverse events occurred.

CONCLUSIONS

The trial confirmed feasibility and supports further research.