title: Dynamics of pleural fluid effusion and chylothorax in the fetus and newborn: role of the lymphatic system.
abstract: Pleural fluid effusion particularly chylothorax is a relatively rare occurrence in the newborn, but when it occurs it is often life-threatening. In this article, we describe and illustrate the morphologic features of the visceral and parietal pleura including pleural lymphatics and the physiology and pathophysiology of pleural fluid balance. The role and function of the lymphatic system in controlling the volume and composition of pleural liquid are detailed and a conceptual scheme presented. Finally, the crucial role of inadequate lymphatic drainage (either functional overload from an imbalance in Starling forces or mechanical insufficiency from lymphatic dysplasia) is emphasized.
authors.affiliation: Neonatal Intensive Care Unit, IRCCS Gaslini Institute, Genoa, Italy. carlobellini@ospedale-gaslini.ge.it
authors.forename: C
authors.initials: C
authors.lastname: Bellini
authors.affiliation: Neonatal Intensive Care Unit, Department of Neonatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Z
authors.initials: Z
authors.lastname: Ergaz
authors.affiliation: Department of Surgery-Unit of Lymphatic Surgery, IRCCS S. Martino University Hospital, IST National Institute for Cancer Research University of Genoa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Boccardo
authors.affiliation: Department of Pediatrics, University of Genoa, Genoa, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Bellini
authors.affiliation: Department of Surgery-Unit of Plastic and Reconstructive Surgery (CCC), IRCCS S. Martino University Hospital, IST National Institute for Cancer Research University of Genoa, Italy.
authors.forename: C C
authors.initials: CC
authors.lastname: Campisi
authors.affiliation: Department of Pediatrics, University of Genoa, Genoa, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Bonioli
authors.affiliation: Neonatal Intensive Care Unit, IRCCS Gaslini Institute, Genoa, Italy.
authors.forename: L A
authors.initials: LA
authors.lastname: Ramenghi
mesh_terms: D002916:Chylothorax / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008208:Lymphatic System / Q000196:embryology* / Q000503:physiopathology*; D010996:Pleural Effusion / Q000503:physiopathology*; D011247:Pregnancy