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International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
Published on: March 12, 2020
Massive chylothorax in small babies
Katherine Cleveland1, Diane Zook, Kayla Harvey
1Mary Bridge/Swedish Pediatric Cardiothoracic Surgery Program, Mary Bridge Children's Health Center, PO Box 5299, M/S 311-1-CTS, Tacoma, WA 98415, USA.
Journal of Pediatric Surgery
|March 24, 2009
Summary
Surgery is effective for massive chylothorax in premature infants. Infants with high-output chylothorax (>50 mL/kg/day) unresponsive to medical therapy may benefit from surgical intervention.
Area of Science:
- Neonatal surgery
- Pediatric thoracic surgery
- Neonatal critical care
Background:
- Chylothorax is a significant concern in neonates, particularly premature infants.
- Management strategies for high-output or massive chylothorax vary, leading to diverse clinical approaches.
Purpose of the Study:
- To review institutional experience with surgical intervention for neonatal chylothorax.
- To refine management strategies for high-output or massive chylothorax in small and premature infants.
Main Methods:
- Retrospective analysis of neonatal patients diagnosed with chylothorax between June 2000 and April 2008.
- Comparison of outcomes between conservative management and surgical intervention for massive chylothorax.
Main Results:
- 23 patients were analyzed; 17 treated conservatively, 6 surgically for massive chylothorax (>50 mL/kg/day).
- Surgical interventions included thoracic duct ligation, mechanical pleurodesis, and fibrin glue.
- Survival was higher in the surgically treated group (83%) versus the conservatively treated group (59%).
- Median chest tube drainage duration was significantly shorter in the surgical group (5 days) compared to the conservative group (14 days).
Conclusions:
- Surgical intervention plays a definitive role in managing massive chylothorax in neonates.
- Massive chylothorax (>50 mL/kg/day) unresponsive to 3 days of maximal medical therapy may warrant surgical consideration.
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