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Congenital chylothorax and pulmonary hypertension complicated with heart failure and hepatopathy
Author(s) -
Oh Jin Hee,
Lee Guisera,
Lee Jung Hyun
Publication year - 2013
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.2012.03700.x
Subject(s) - medicine , chylothorax , mechanical ventilation , pulmonary hypertension , respiratory distress , persistent pulmonary hypertension , bronchopulmonary dysplasia , respiratory failure , ventilation (architecture) , nitric oxide , hypoplasia , cardiology , anesthesia , surgery , gestational age , pregnancy , mechanical engineering , biology , engineering , genetics
Respiratory difficulty resulting from congenital chylothorax is usually relieved by postnatal thoracentesis, closed chest drainage, and oxygen therapy. However, early occurrence of congenital chylothorax or accumulation of a large amount of chylous fluid sometimes leads to pulmonary hypoplasia or persistent pulmonary hypertension of the newborn, which requires further customized mechanical ventilatory support. In these cases, conventional mechanical ventilation is primarily used during initial treatment and is later replaced by high‐frequency ventilation, but the advantages of inhaled nitric oxide treatment have rarely been described. This case suggests the benefits of inhaled nitric oxide in patients with congenital chylothorax, even when mechanical ventilation cannot improve respiratory distress because of severe pulmonary hypertension of the newborn leading to right cardiac dysfunction and possibly cholestasis.