Dietary modification of chyle composition in chylothorax

Jensen, Gordon L.; Mascioli, Edward A.; Meyer, Laura P.; Lopes, Sarah M.; Bell, Stacey J.; Babayan, Vigen K.; Blackburn, George L.; Bistrian, Bruce R.

doi:10.1016/0016-5085(89)90650-1

Cited by 67 publications

(41 citation statements)

References 18 publications

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“…A low-fat diet with medium-chain triglycerides, which to the largest extent are absorbed directly into the blood, will cause the chyle to decrease in amount, but there will still be a flow [34]. The next step is total parenteral nutrition, which will diminish flow even further.…”

Section: Treatmentmentioning

confidence: 99%

Chylothorax and pseudochylothorax

Hillerdal¹

1997

Eur Respir J

198

146

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Chylothorax is the occurrence of chylus (lymph) in the pleura due to damage to the thoracic duct. There is a high content of triglycerides, and chylomicrons can be seen. It is usually right-sided, since most of the duct is within the right hemithorax. With damage at the level of the aorta, the chyle will appear on the left.Traumatic rupture occurs after accidents or surgery. Of nontraumatic causes, the most common is a malignant lymphoma. Computed tomography (CT) scan of the thorax and upper abdomen should be performed. Lymphography can show where the leakage or blockage is situated. With repeated drains, large amounts of fat, proteins, and lymphocytes are lost. Treatment is with low-fat diet or parenteral nutrition to decrease the amount of chyle, but chemical pleurodesis or ligation of the thoracic duct, usually via thoracoscopy, is often necessary.Pseudochylothorax (cholesterol pleurisy) occurs with long-standing fluid in a fibrotic pleura. The fluid has a high content of cholesterol but no triglycerides or chylomicrons. In both conditions, the pleural fluid is thick, opalescent, whitish or the colour of café-au-lait.

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Section: Treatmentmentioning

confidence: 99%

Chylothorax and pseudochylothorax

Hillerdal¹

1997

Eur Respir J

198

146

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“…However, such a diet may induce severe malnutrition from deficiency of energy, liposoluble vitamins and essential (ω3 and ω6) fatty acids. Thus, an MCT diet is indicated to maintain energy intake and to limit lymph flow, even if not all MCTs are absorbed directly into the portal system [14].Oral or intravenous supplementation of ADEK vitamins and essential fatty acids is also recommended. In our cohort, all the children received an MCT diet, after transient TPN in 4 children.…”

Section: Discussionmentioning

confidence: 97%

Therapeutic strategies for idiopathic chylothorax

Epaud¹,

Dubern²,

Larroquet³

et al. 2008

Journal of Pediatric Surgery

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“…Dietary interventions (low-fat diet, medium-chain triglyceride diet, total parenteral nutrition, etc) are commonly used, and may occasionally be effective, but are difficult for patients to maintain. [7][8][9][10] Surgical and percutaneous radiological interventions (eg, thoracic duct ligation/embolization, pleuroperitoneal shunting, chemical pleurodesis) may be effective but can be associated with morbidity and mortality. [11][12][13][14][15][16] Octreotide therapy has been used with variable efficacy in a predominantly pediatric population.…”

Section: Discussionmentioning

confidence: 99%