Post-operative chylothorax in children: an evidence-based management algorithm.
OBJECTIVE
To develop an evidence-based algorithm for the therapeutic approach to the management of post-operative chylothorax.


METHODS
Review and analysis of published literature sourced from Medline from 1964-2007.


RESULTS
Understanding the pathophysiology of chylothorax and the anatomical structure of the thoracic duct assisted clinical decision making in the management of a patient with chylothorax. Treatment options for post-operative chlothorax include conservative management with medium chain triglyceride-enriched diet or total parenteral nutrition in combination with adequate drainage of pleural fluid, somatostatin or octreotide therapy or surgical intervention. Based on analysis of the available evidence an algorithm for therapeutic approach to the management of post-operative chylothorax has been developed.


CONCLUSIONS
Post-operative chylothorax is associated with significant morbidity and prolonged hospitalization. An evidence based algorithm to guide the therapeutic approach to management of post-operative chylolthorax is proposed.
Panthongviriyakul
Charnchai
C
Murdoch Childrens Research Institute, University of Melbourne, Victoria, Australia.
Bines
Julie E
JE
D000465:Algorithms; D002916:Chylothorax / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D019317:Evidence-Based Medicine; D006330:Heart Defects, Congenital; D006801:Humans; D011182:Postoperative Care