Chylothorax development in infants and children in the UK
Caroline Haines1, Bronagh Walsh2, Margaret Fletcher3
1Bristol Royal Hospital for Children, Bristol, UK University of Southampton, Southampton, UK.
Archives of Disease in Childhood
|April 8, 2014
Summary
Chylothorax in UK children is rare, often following cardiac surgery. Management involves pleural catheters and special diets, but prolonged hospital stays and significant mortality (12.2%) highlight the need for national guidance.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Critical Care Medicine
Background:
- Chylothorax, the accumulation of lymphatic fluid in the pleural space, is a rare but serious complication in infants and children.
- Understanding its incidence, patient demographics, and treatment outcomes is crucial for improving patient care and resource allocation.
Purpose of the Study:
- To determine the incidence of chylothorax in pediatric patients across the UK.
- To describe the typical patient profile, common causes, and management strategies employed.
- To report on the outcomes, including hospital stay duration and mortality rates.
Main Methods:
- A prospective study utilizing the British Paediatric Surveillance Unit (BPSU) to identify cases of chylothorax in children aged 24 weeks gestation to 16 years.
- Clinicians completed questionnaires detailing presentation, diagnosis, management, and outcomes.
- Data were cross-referenced with three additional sources for verification.
Main Results:
- The overall incidence of chylothorax in UK children was 0.0014%, significantly higher (3.2%) following cardiac surgery.
- Infants under 12 months had the highest incidence (16 per 100,000). Cardiac surgery was the leading cause (65.1%).
- Common treatments included intercostal pleural catheters (86.5%) and medium-chain triglyceride (MCT) diets (89%). Mortality was 12.2%, with prolonged hospital stays.
Conclusions:
- Chylothorax is uncommon in UK children but strongly associated with cardiac surgical procedures.
- Current management strategies are varied, indicating a need for standardized national guidelines to optimize care.
- The significant impact on patients, families, and healthcare resources necessitates further research and practice development.
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