Key result
Conservative therapy resolves post-cardiac surgery pediatric chylothorax in ~80% of patients within two weeks.
Case Report (n=5)
No
Answers are grounded in this paper and cite their sources.
May warrant initial conservative management in pediatric post-cardiac surgery chylothorax; leaves open need for larger prospective validation.
In the past 12 years, we have encountered five cases of chylothorax following intrapericardial cardiac surgery.Four of the patients were successfully treated by conservative therapy, namely, chest drainage, low fat diet, MCT (medium chain triglyceride) and cardiac diuretic. In these patients, the amount of chylus was reduced within two weeks.Only one case needed ligation of the thoracic duct ligation after two months of conservative therapy.The above results indicate that, patients with chylothorax after intrapericardial operation should be treated with a non fat diet from the beginning. When conservative treatment is not effective within two weeks, surgical ligation of the thoracic duct should be chosen.
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Ishikawa et al. (1990) conducted a case report in Chylothorax following intrapericardial cardiac surgery (n=5). Conservative therapy (chest drainage, fat-free diet, medium-chain triglycerides, diuretics, cardiotonics) and surgical thoracic duct ligation was evaluated on Resolution of chylothorax with conservative therapy. Conservative therapy with chest drainage, a non-fat diet, medium-chain triglycerides, and diuretics resolved post-cardiac surgery chylothorax in 4 of 5 pediatric patients within two weeks.
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