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. 2022 Oct;14(10):3719-3726.
doi: 10.21037/jtd-22-474.

Treatment and outcomes of chylothorax in children: 20-year experience of a single institute

Kanokpan Ruangnapa  1 , Wanaporn Anuntaseree  1 , Kantara Saelim  1 , Pharsai Prasertsan  1 , Maneerat Puwanant  1 , Supaporn Dissanevate  1
Affiliations

Treatment and outcomes of chylothorax in children: 20-year experience of a single institute

Kanokpan Ruangnapa et al. J Thorac Dis. 2022 Oct.

Abstract

Background: Chylothorax is an uncommon cause of pleural effusion in children. This study aimed to determine the characteristics, treatment strategies, and outcomes of chylothorax in children from a single institute.

Methods: The 65 episodes of chylothorax in patients aged 0-15 years who were diagnosed and received treatment in Songklanagarind Hospital between January 2001 and December 2020 were retrospectively review and analyzed.

Results: Of the 65 episodes, 80% were postoperative chylothorax, and were mostly related to cardiac surgery. The most common treatment strategy employed was dietary modification (64.6%). Octreotide was used as adjunctive therapy in 33.8%. Most cases of chylothorax were successfully treated by conservative treatment, while 10.7% required surgical therapy. The median time to resolution of chylothorax was 21 days [interquartile range (IQR): 8-33 days]. Young children aged <1 year were more likely to require mechanical ventilation and develop ventilator-associated pneumonia and catheter-related complications. The factors associated with death or prolonged hospitalization (>28 days) were non-postoperative chylothorax, use of total parental nutrition (TPN) >14 days, hypoalbuminemia, and ventilator-associated pneumonia.

Conclusions: Most (89.2%) cases of chylothorax were successfully treated conservatively using dietary modification and octreotide therapy. The modifiable risk factors for death or prolonged hospitalization were use of TPN >14 days and hypoalbuminemia.

Keywords: Chylothorax; dietary modification; octreotide therapy; pediatrics; pleural effusion.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-22-474/coif). The authors have no conflicts of interest to declare.

Comment in

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