title: Post-operative chylothorax in children: an evidence-based management algorithm.
abstract: 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.
authors.affiliation: Murdoch Childrens Research Institute, University of Melbourne, Victoria, Australia.
authors.forename: Charnchai
authors.initials: C
authors.lastname: Panthongviriyakul
authors.forename: Julie E
authors.initials: JE
authors.lastname: Bines
mesh_terms: D000465:Algorithms; D002916:Chylothorax / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D019317:Evidence-Based Medicine; D006330:Heart Defects, Congenital; D006801:Humans; D011182:Postoperative Care