Chylothorax in Children

Büttiker, Vera; Fanconi, Sergio; Burger, R.

doi:10.1378/chest.116.3.682

Cited by 218 publications

(64 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An unresolved critical issue is the early identification of babies for whom morbidity of medical therapy will exceed that of early surgical therapy [1,10]. Variance in perception on this issue accounts for preoperative periods of medical therapy that range from days to weeks [1][2][3][4][5][6][7][8][9][10]. In an effort to enhance consistency and quality in our surgical practice, we designed an algorithm to help select appropriate surgical candidates.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Massive chylothorax in small babies

Cleveland

Zook

Harvey

et al. 2009

Journal of Pediatric Surgery

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

“…For chylothorax, there is considerable variability in the definition of failure of medical or conservative treatment and the optimal timing and type of surgical intervention [1][2][3][4][5][6][7][8][9][10]. There are no data assessing the relationship between the morbidity of maximal medical therapy or surgical therapy and the size of the patient.…”

mentioning

confidence: 99%

Massive chylothorax in small babies

Cleveland

Zook

Harvey

et al. 2009

Journal of Pediatric Surgery

View full text Add to dashboard Cite

“…Enteral nutrition with medium-chain triglycerides and total parenteral nutrition have been successfully employed. In this case, the parenteral nutrition was not possible due to shortage in the pharmacy of the hospital [10] [11].…”

Section: Discussionmentioning

confidence: 99%

Congenital Chylothorax: Rapid and Effective Response to Polyvidone Iodine

Maoulainine¹,

Slitine²,

Erguig³

2016

OJPed

View full text Add to dashboard Cite

Introduction: Congenital chylothorax, defined by the presence of chyle in the pleural cavity, is a rare congenital disorder of varying severity. The objective of this study was to report a case of idiopathic congenital chylothorax treated with povidone iodine effectively without side effects after failure of conservative treatment by chest drainage. Case presentation: A term female Newborn was admitted in the neonatal intensive care unit at 16 days of life, for respiratory distress. The Clinical examination objectified a Sliverman score of 3/10 with a pleural effusion syndrome. The chest radiography confirmed the pleural effusion and the analysis of the pleural fluid after aspiration confirmed the chylothorax, with a protein rate of 35 g/l, Triglycerids 37 mg/L, and Leukocytes count was 1140/ml with 90% lymphocytes. A chest drainage was performed on the seventh day but followed by the recurrence of the effusion. The use of 5 ml of 4% povidone iodine in the pleural space as a chemical pleurodesis was performed. The clinical and radiological evolution was favorable after 24 hours without relapse or side effects such as allergic reaction or worsening of the respiratory condition. Thoracic ultrasound was performed after 15 days, having objectified minimal right side effusion measuring 5 mm maximum thickness. Conclusion: Chemical pleurodesis by the polyvidone iodine in the chylothorax appears to be affordable and effective, and needs to be more considerate in the conservative treatment of congenital chylothorax.

show abstract

“…Six neonates (3 male, 3 female) with the diagnosis according to the definition of chylothorax in pediatric patients [2] were prospectively enrolled in the study between January 2004 and December 2007 at the Department of Pediatrics, Medical University, Innsbruck, Austria. Exact gestation ages were 37 + 5/7, 38 + 2/7, 38 + 3/7, 39 + 1/7, 40 + 4/7 and 41 + 0/7, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…Exact gestation ages were 37 + 5/7, 38 + 2/7, 38 + 3/7, 39 + 1/7, 40 + 4/7 and 41 + 0/7, respectively. Acute chylothorax within 48 h after thoracic surgery due to transposition of the great arteries was diagnosed when the pleural effusion contained 6 1,000 cells/ l, with a lymphocyte fraction 1 80%, and triglycerides 1 1.1 mmol/l [2] . Analysis of lymphocyte subpopulations from chyle and peripheral blood was performed at the time point of diagnosis within 48 h after beginning of pleural effusion.…”

Section: Methodsmentioning

confidence: 99%

Accumulation of CD8+CD45RA+CD62L+ T Cells in Acute Chylothorax in Neonates

Prelog

Kipp

Kern³

et al. 2008

Neonatology

View full text Add to dashboard Cite

Background: Acute chylothorax in neonates is a rare disease but results in significant loss of lymphatic cells. Objectives: The purpose of the study was to determine whether acute chylothorax in neonates results in quantitative changes of lymphocyte subpopulations in peripheral blood and chyle. Methods: 6 neonates who had acute chylothorax after thoracic surgery due to transposition of the great arteries were prospectively enrolled in the study. Peripheral blood mononuclear cells (PBMC) and chylous fluid mononuclear cells (CFMC) including CD45RA+ and CD45RO+ T cells and the expression of the lymphocyte homing marker CD62L were investigated by fluorescence-activated cell sorting. Results: In chyle, CD3+CD45RA+ T cells were significantly increased compared to peripheral blood (PMBC: median 65.8% of CD3+; range 32.3–76.9% vs. CFMC: 90.3%; 68.6–94.4%) (p = 0.02). In chyle, changes of percentages of the CD45RA+ were limited to CD8-expressing T cells (CD8+CD45RA+: PBMC: 77.3%; 69.3–85.6% vs. CFMC: 93.2%; 86.3–98.5%) (p = 0.02). The CD8+CD45RA+ were mainly CD62L+ (PBMC: 59.4%; 31.6–62.0% vs. CFMC: 87.8%; 62.7–90.7%) (p = 0.02). Conclusions: The study gives evidence that acute chylothorax in neonates results in immunophenotypic alterations and accumulation of certain T-cell subpopulations in the pleural cavity. Although limited by small numbers of patients due to the rare manifestation of the disease, we were able to demonstrate an abundance of CD8+CD45RA+ T cells expressing CD62L in the chyle compared to peripheral blood. However, whether CD62L expression may contribute to the accumulation of CD8+CD45RA+ T cells in chyle and whether quantitative changes of these specific cells are of clinical relevance has to be determined.

show abstract

Chylothorax in Children

Cited by 218 publications

References 16 publications

Massive chylothorax in small babies

Massive chylothorax in small babies

Congenital Chylothorax: Rapid and Effective Response to Polyvidone Iodine

Accumulation of CD8+CD45RA+CD62L+ T Cells in Acute Chylothorax in Neonates

Contact Info

Product

Resources

About