Congenital chylothorax: clinical course and prognostic significance

Zivanit Ergaz, Benjamin Bar-Oz, Ido Yatsiv, Ilan Arad
Pediatric Pulmonology 2009, 44 (8): 806-11

OBJECTIVE: To determine the underlying etiology, associated malformations, clinical course, and prognostic significance of congenital chylothorax.

STUDY DESIGN: A retrospective analysis of 11 neonates admitted to our neonatal intensive care unit with congenital chylothorax between January 2000 and June 2008. The post-discharge clinical and developmental course was evaluated by a telephone survey performed in July 2008.

RESULTS: Antenatal diagnosis was established in 9 out of 11 infants by ultrasound examination; 5 had intrauterine pleural drainage. Eight infants had either structural or chromosomal abnormalities. The postnatal treatment included mechanical ventilation, drainage of pleural fluid and feeding with enriched medium chain triglyceride formula. Somatostatin was administered in one case. Six patients developed nosocomial infections. Two patients died after resolution of the chylothorax from deteriorating renal failure. Seven patients were traced for follow up and six of them achieved age appropriate developmental milestones.

CONCLUSION: The recovery from chylothorax and future prognosis were dependent on the underlying etiology. Chylothorax was often a secondary event, with apparently favorable clinical and developmental prognosis when the underlying or/and associated condition was treatable.

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