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.
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