Post-operative chylothorax in children: An evidence-based management algorithm

Journal of Paediatrics and Child Health

Volumn 44, Issue 12, 2008, Pages 716-721

  Panthongviriyakul, Charnchai ^a   Bines, Julie E ^a,b  

^a UNIVERSITY OF MELBOURNE   (Australia)

^b ROYAL CHILDREN'S HOSPITAL   (Australia)

Author keywords

Cardiac Surgery; Chylothorax; Congenital heart disease; Medium chain triglyceride diet; Octreotide; Somatostatin

Indexed keywords

MEDIUM CHAIN TRIACYLGLYCEROL;

ARTICLE; CHYLOTHORAX; CLINICAL TRIAL; CONSERVATIVE TREATMENT; CONTROLLED CLINICAL TRIAL; DIAGNOSTIC PROCEDURE; DIET THERAPY; DISEASE COURSE; EVIDENCE BASED MEDICINE; HUMAN; MEDICAL DECISION MAKING; MEDICAL LITERATURE; PARENTERAL NUTRITION; PLEURA FLUID; POSTOPERATIVE PERIOD; PRIORITY JOURNAL; PUBLICATION; RANDOMIZED CONTROLLED TRIAL; SURGICAL DRAINAGE;

ALGORITHMS; CHYLOTHORAX; EVIDENCE-BASED MEDICINE; HEART DEFECTS, CONGENITAL; HUMANS; POSTOPERATIVE CARE;

EID: 58149099471     PISSN: 10344810     EISSN: 14401754     Source Type: Journal    
DOI: 10.1111/j.1440-1754.2008.01412.x     Document Type: Article

References (76)

1. Doerr CH, Allen MS, Nichols FC III., Ryu JH. Etiology of chylothorax in 203 patients. Mayo Clin. Proc. 2005 80 : 867 70.
2. Beghetti M, La Scala G, Belli D, Bugmann P, Kalangos A, Le Coultre C. Etiology and management of pediatric chylothorax. J. Pediatr. 2000 136 : 653 8.
3. Le Coultre C, Oberhansli I, Mossaz A, Bugmann P, Faidutti B, Belli DC. Postoperative chylothorax in children: differences between vascular and traumatic origin. J. Pediatr. Surg. 1991 26 : 519 23.
4. Bond SJ, Guzzetta PC, Snyder ML, Randolph JG. Management of pediatric postoperative chylothorax. Ann. Thorac. Surg. 1993 56 : 469 73.
5. Buttiker V, Fanconi S, Burger R. Chylothorax in children: guidelines for diagnosis and management. Chest 1999 116 : 682 7.
6. Valentine VG, Raffin TA. The management of chylothorax. Chest 1992 102 : 586 91.
7. Efrati O, Barak A. Pleural effusions in the pediatric population. Pediatr. Rev. 2002 23 : 417 26.
8. Allen EM, van Heeckeren DW, Spector ML, Blumer JL. Management of nutritional and infectious complications of postoperative chylothorax in children. J. Pediatr. Surg. 1991 26 : 1169 74.
9. Densupsoontorn NS, Jirapinyo P, Wongarn R et al. Management of chylothorax and chylopericardium in pediatric patients: experiences at Siriraj Hospital, Bangkok. Asia Pac. J. Clin. Nutr. 2005 14 : 182 7.
10. Oshio T, Matsumura C. Chylothorax following Bochdalek herniorrhaphy in an infant. J. Pediatr. Surg. 1983 18 : 298 9.
11. Casaccia G, Crescenzi S, Palamides F, Catalano OA, Bagolan P. Pleural effusion requiring drainage in congenital diaphragmatic hernia: incidence, aetiology and treatment. Pediatr. Surg. Int. 2006 22 : 585 8.
12. Clarke SA, Lakhoo K, Sherwood W. Somatostatin for intractable postoperative chylochorax in a premature infant. Pediatr. Surg. Int. 2005 21 : 390 1.
13. Chan EH, Russell JL, Williams WG, Van Arsdell GS, Coles JG, McCrindle BW. Postoperative chylothorax after cardiothoracic surgery in children. Ann. Thorac. Surg. 2005 80 : 1864 70.
14. Nguyen DM, Shum-Tim O, Dobell ARC, Tchervenkov CI. The management of chylothorax/chylopericardium following pediatric cardiac surgery: a 10-year experience. J. Card. Surg. 1995 10 : 302 8.
15. Cormack BE, Wilson NJ, Finucane K, West CM. Use of Monogen for pediatric postoperative chylothorax. Ann. Thorac. Surg. 2004 77 : 301 5.
16. Cannizzaro V, Frey B, Bernet-Buettiker V. The role of somatostatin in the treatment of persistent chylothorax in children. Eur. J. Cardiothorac. Surg. 2006 30 : 49 53.
17. Teba L, Dedhia HV, Bowen R, Alexander JC. Chylothorax review. Crit. Care Med. 1985 13 : 49 52.
18. Bridges ND, Mayer JE, Lock JE et al. Effect of baffle fenestration on outcome of the modified Fontan operation. Circulation 1992 86 : 1762 9.
19. Gentles TL, Mayer JR JE, Gauvreau K, Newburger JW, Lock JE, Kupferschmid JP et al. Fantan operation in five hundred consecutive patients: factors influencing early and late outcome. J. Thorac. Cardiovasc. Surg. 1997 114 : 376 91.
20. Hsu DT, Quaegebeur JM, Ing FF, Selber EJ, Lamour JM, Gersony WM. Outcome after the single-stage, nonfenestrated Fontan procedure. Circulation 1997 96 (Suppl. II 335 40.
21. Petrossian E, Reddy VM, McElhinney DB et al. Early results of the extracardiac conduit Fontan operation. J. Thorac. Cardiovasc. Surg. 1999 117 : 688 96.
22. Azakie A, McCrindle BW, van Arsdell G et al. Extracardiac conduit versus lateral tunnel cavopulmonary connections at a single institution: impact on outcomes. J. Thorac. Cardiovasc. Surg. 2001 122 : 1219 28.
23. Atik E, Ikari NM, Martins TC, Barbero-Marcial M. Fontan operation and the cavopulmonary technique: immediate and late results according to the presence of atrial fenestration. Arq. Bras. Cardiol. 2002 78 : 162 6.
24. Berman W, Fripp RR, Yabek SM, Wernly J, Corlew S. Great vein and right atrial thrombosis in critically ill infant and children with central venous lines. Chest 1991 99 : 963 7.
25. Dhande V, Kattwinkel J, Alford B. Recurrent bilateral pleural effusion secondary to superior vena cava obstruction as a complication of central venous catheterization. Pediatrics 1983 72 : 109 13.
26. Van Veldhuizen PJ, Taylor S. Chylothorax: a complication of a left subclavian vein thrombosis. Am. J. Clin. Oncol. 1996 19 : 99 101.
27. Puntis JW, Roberts KD, Handy D. How should chylothorax be managed? Arch. Dis. Child. 1987 62 : 593 6.
28. Marts BC, Naunheim KS, Fiore AC, Pennington DG. Conservative versus surgical management of chylothorax. Am. J. Surg. 1992 164 : 532 5.
29. Magder S. Central venous pressure monitoring. Curr. Opin. Crit. Care 2006 12 : 219 27.
30. Rimensberger PC, Muller-Schenker B, Kalangos A, Beghetti M. Treatment of a persistent postoperative chylothorax with somatostatin. Ann. Thorac. Surg. 1998 66 : 253 4.
31. Lam JC, Aters S, Tobias JD. Initial experience with octreotide in the pediatric population. Am. J. Ther. 2001 8 : 409 15.
32. Tibballs J, Soto R, Bharucha T. Management of newborn lymphangiectasia and chylothorax after cardiac surgery with octreotide infusion. Ann. Thorac. Surg. 2004 77 : 2213 5.
33. Hashim S, Roholt HB, Babayan VK, Vanitallie TB Treatment of chyluria and chylothorax with medium-chain triglyceriden. N. Engl. J. Med. 1964 270 : 756 61.
34. Peitersen B, Jacobsen B. Medium chain triglycerides for treatment of spontaneous, neonatal chylothorax. Lipid analysis of the chyle. Acta Paediatr. Scand. 1977 66 : 121 5.
35. Kosloske AM, Martin LW, Schubert WK. Management of chylothorax in children by thoracentesis and medium chain triglyceride feedings. J. Pediatr. Surg. 1974 9 : 365 71.
36. Au M, Weber TR, Fleming RE. Successful use of somatostatin in a case of neonatal chylothorax. J. Pediatr. Surg. 2003 38 : 1106 7.
37. Goto M, Kawamata K, Kitano M, Watanabe K, Chiba Y. Treatment of chylothorax in a premature infant using somatostatin. J. Perinatol. 2003 23 : 563 4.
38. Lamberts SW, van der Lely AJ, de Herder WW, Hofland LJ. Octreotide. N. Engl. J. Med. 1996 334 : 246 54.
39. Ulibarri JI, Sanz Y, Fuentes C, Mancha A, Aramendia M, Sanchez S. Reduction of lymphorrhagia from ruptured thoracic duct by somatostatin. Lancet 1990 336 : 258.
40. Cheung Y, Leung MP, Yip M. Octreotide for treatment of postoperative chylothorax. J. Pediatr. 2001 139 : 157 9.
41. Pratap U, Slavik Z, Ofoe VD, Onuzo O, Franklin RCG. Octreotide to treat postoperative chylothorax after cardiac operations in children. Ann. Thorac. Surg. 2001 72 : 1740 2.
42. Mohseni-Bod H, Macrae D, Slavik Z. Somatostatin analog (octreotide) in management of neonatal postoperative chylothorax: is it safe? Pediatr. Crit. Care Med. 2004 5 : 356 7.
43. Lim KA, Kim SH, Huh J et al. Somatostatin for postoperative chylothorax after surgery for children with congenital heart disease. J. Korean Med. Sci. 2005 20 : 947 51.
44. Rosti L, De Battisti F, Butera G et al. Octreotide in the management of postoperative chylothorax. Pediatr. Cardiol. 2005 26 : 440 3.
45. Roehr CC, Jung A, Proquitte H et al. Somatostatin or octreotide as treatment options for chylothorax in young children: a systematic review. Intensive Care Med. 2006 : 32 : 650 7.
46. Yildirim SV, Kervancioglu M, Saritas B, Varan B, Mercan S, Tokel K. Octreotide infusion for the treatment of chylothorax in pediatric cardiac intensive care unit. Anadolu. Kardiyol. Derg. 2005 5 : 317 8.
47. Scarpignato C, Pelosini I. Somatostatin for upper gastrointestinal hemorrhage and pancreatic surgery. A review of its pharmacology and safety. Digestion 1999 60 (Suppl. 3 1 16.
48. Hengl G, Prager J, Pointner H. The influence of somatostatin on the absorption of triglycerides in partially gastrectomized subjects. Acta. Hepatogastroenterol. 1979 26 : 392 5.
49. Buettiker V, Hug MI, Burger R, Baenziger O. Somatostatin: a new therapeutic option for the treatment of chylothorax. Intensive Care Med. 2001 27 : 1083 6.
50. de Herder WW, Lamberts SWJ. Somatostatin and somatostatin analogues: diagnostic and therapeutic uses. Curr. Opin. Oncol. 2002 14 : 53 7.
51. Hamdan MA, Gaeta ML. Octreotide and low-fat breast milk in postoperative chylothorax. Ann. Thorac. Surg. 2004 77 : 2215 7.
52. Rasiah SV, Oei J, Lui K. Octreotide in the treatment of congenital chylothorax. J. Paediatr. Child Health 2004 40 : 585 8.
53. Paget-Brown A, Kattwinkel J, Rodgers BM, Michalsky MP. The use of octreotide to treat congenital chylothorax. J. Pediatr. Surg. 2006 41 : 845 7.
54. Matsuo T, Matsumoto M, Sugita T et al. Treatment of persistent chylothorax with somatostatin. Ann. Thorac. Surg. 2003 76 : 340 1.
55. Pettitt TW, Caspi J, Borne A. Treatment of persistent chylothorax after Norwood procedure with somatostatin. Ann. Thorac. Surg. 2002 73 : 977 9.
56. Satpathy C, Mishra TK, Satpathy R, Satpathy HK, Barone E. Diagnosis and management of diastolic dysfunction and heart failure. Am. Fam. Physician 2006 73 : 841 6.
57. Momma K. ACE inhibitors in pediatric patients with heart failure. Paediatric Drugs 2006 8 : 55 69.
58. Stern H, Weil J, Genz T, Vogt W, Buhlmeyer K. Captopril in children with dilated cardiomyopathy: acute and long-term effects in a prospective study of hemodynamic and hormonal effects. Pediatr. Cardiol. 1990 11 : 22 8.
59. Dibner-Dunlap ME, Smith ML, Kinugawa T, Thames MD. Enalaprilat augments arterial and cardiopulmonary baroreflex control of sympathetic nerve activity in patients with heart failure. J. Am. Coll. Cardiol. 1996 27 : 358 64.
60. Wagner F, Yeter R, Bisson S, Siniawski H, Hetzer R. Beneficial hemodynamic and renal effects of intravenous enalaprilat following coronary artery bypass surgery complicated by left ventricular dysfunction. Crit. Care Med. 2003 31 : 1421 8.
61. Palazzuoli A, Quatrini I, Vecchiato L et al. Left ventricular diastolic function improvement by carvedilol therapy in advanced heart failure. J. Cardiovasc. Pharmacol. 2005 45 : 563 8.
62. Rothman A, Mayer JE, Freed MD. Treatment of chronic pleural effusions after the Fontan procedure with prednisone. Am. J. Cardiol. 1987 60 : 408 9.
63. Goens MB, Campbell D, Wiggins JW. Spontaneous chylothorax in Noonan syndrome. Treatment with prednisone. Am. J. Dis. Child 1992 146 : 1453 6.
64. Husain SJ, Sadiq F, Zubairi AB, Khan JA. Massive unilateral chylous pleural effusion: a rare initial presentation of Behcet's disease. Singapore Med. J. 2006 47 : 978 80.
65. Saissy JM, Atmani M, Dimou M, Drissi-Kamili N, Taobane H, Ducourau JP. Thrombosis of the superior vena cava in Behcet's disease. Apropos of a case associated with chylothorax. Med. Trop. (Mars) 1985 45 : 309 12.
66. Takahashi A, Ogawa C, Kanazawa T et al. Remission induced by interferon alfa in a patient with massive osteolysis and extension of lymph- hemangiomatosis: a severe case of Gorham-Stout syndrome. J. Pediatr. Surg. 2005 40 : E 47 50.
67. de Berranger E, Colinet S, Michaud L et al. Severe selenium deficiency secondary to chylous loss. JPEN 2006 30 : 173 4.
68. McBride ME, Drass JC, Berkenbosch JW, Wilson WR Jr., Tobias JD. Hypogamma globulinemia complicating chylothorax after cardiac surgery in two infants. J. Cardiothorac. Vasc. Anesth. 2001 15 : 358 61.
69. Mohan H, Paes ML, Haynes S. Use of intravenous immunoglobulins as an adjunct in the conservative management of chylothorax. Paediatr. Anaesth. 1999 9 : 89 92.
70. Bernet-Buettiker V, Waldvogel K, Cannizzaro V, Albisetti M. Antithrombin activity in children with chylothorax. Eur. J. Cardiothorac. Surg. 2006 29 : 406 9.
71. Patterson GA, Todd TR, Delarue NC, Ilves R, Pearson FG, Cooper JD. Supradiaphragmatic ligation of the thoracic duct in intractable chylous fistula. Ann. Thorac. Surg. 1981 32 : 44 9.
72. Stenzl W, Rigler B, Tscheliessnigg KH, Beitzke A, Metzler H. Treatment of postsurgical chylothorax with fibrin glue. Thorac. Cardiovasc. Surg. 1983 31 : 35 6.
73. Nguyen D, Tchervenkov CI. Successful management of postoperative chylothorax with fibrin glue in a premature neonate. Can. J. Surg. 1994 37 : 158 60.
74. Azizkhan RG, Canfield J, Alford BA, Rodgers BM. Pleuroperitoneal shunts in the management of neonatal chylothorax. J. Pediatr. Surg. 1983 18 : 842 50.
75. Rheuban KS, Kron IL, Carpenter MA, Gutgesell HP, Rodgers BM. Pleuroperitoneal shunts for refractory chylothorax after operation for congenital heart disease. Ann. Thorac. Surg. 1992 53 : 85 7.
76. Murphy MC, Newman BM, Rodgers BM. Pleuroperitoneal shunts in the management of persistent chylothorax. Ann. Thorac. Surg. 1989 48 : 195 200.