Effectiveness of medium-chain triglycerides in chylothorax management: A review

Chylothorax, a rare condition, results when excessive chyle accumulates in the thoracic region. The etiological basis of chylothorax is categorized into three types: spontaneous, non-spontaneous, and idiopathic. However, it is usually manifested as a post-operative complication after thoracic or abdominal surgeries. Due to its rarity, limited research has been done to explore its causes and treatment. This review aims to explore treatment options for chylothorax with a special focus on its management through medium-chain triglyceride provision. In this article, we discussed the etiology, complications, clinical manifestations, and diagnosis of chylothorax, and reviewed the effectiveness of the medium-chain triglycerides diet as a first-line approach in the treatment of chylothorax. As chylothorax diagnosis is established by the presence of triglycerides in chyle fluid, the provision of medium-chain triglycerides has been thought to be an effective treatment strategy due to their efficient absorption. However, chylothorax complications have not only included immunological and localized complications, but nutritional complications are also an important concern during their management. Medium-chain triglyceride provision has emerged as an important therapeutic aid in the medical nutrition therapy of chylothorax. However, there is no current consensus on specific parameters reflecting the effectiveness of medium-chain triglycerides in chylothorax. Therefore, it is reflected by reduced chyle output, improved nutritional status, shortened drainage duration, and decreased need for surgical intervention in cases where medium-chain triglycerides intervention was done.