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Post‐operative chylothorax in children: An evidence‐based management algorithm
Author(s) -
Panthongviriyakul Charnchai,
Bines Julie E
Publication year - 2008
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/j.1440-1754.2008.01412.x
Subject(s) - medicine , chylothorax , octreotide , intensive care medicine , somatostatin , parenteral nutrition , algorithm , conservative management , surgery , computer science
Aim: To develop an evidence‐based algorithm for the therapeutic approach to the management of post‐operative chylothorax. Methods: Review and analysis of published literature sourced from Medline from 1964–2007. Results: Understanding the pathophysiology of chylothorax and the anatomical structure of the thoracic duct assisted clinical decision making in the management of a patient with chylothorax. Treatment options for post‐operative chlothorax include conservative management with medium chain triglyceride‐enriched diet or total parenteral nutrition in combination with adequate drainage of pleural fluid, somatostatin or octreotide therapy or surgical intervention. Based on analysis of the available evidence an algorithm for therapeutic approach to the management of post‐operative chylothorax has been developed. Conclusion: Post‐operative chylothorax is associated with significant morbidity and prolonged hospitalization. An evidence based algorithm to guide the therapeutic approach to management of post‐operative chylolthorax is proposed.