title: Nutritional support in adults with chyle leaks.
abstract: We provide a practical approach to the complex management problem of chyle leaks that occur after surgical procedures or trauma, or when they occur spontaneously in association with malignancies. The volume of chyle loss causes significant problems due to loss of fluid, electrolytes, proteins, and lymphocytes, causing deleterious effects on wound healing and immunity. Enteral feeding is not always possible as long chain fatty acids are absorbed through the intestinal lacteals, the original source of chyle. Regular diets increase the leak and delay healing. Nutritional support involves coordinated care between healthcare providers to provide a combination of various modalities, including nil by mouth, parenteral nutrition, enteral feeding with formula modifications, and oral diet.
authors.affiliation: Adult Critical Care and eICU, Advocate Health Care, Oakbrook, IL, USA; Division of Surgical Critical Care, Stroger Hospital of County, Chicago, IL, USA. Electronic address: Ksriram41@hotmail.com.
authors.forename: Krishnan
authors.initials: K
authors.lastname: Sriram
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado, School of Medicine, Aurora, CO, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Meguid
authors.affiliation: Professor Emeritus, Surgery, Neuroscience and Nutrition, Department of Surgery, Upstate Medical University, University Hospital, Syracuse, NY, USA.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Meguid
mesh_terms: D000328:Adult; D002913:Chyle; D002916:Chylothorax / Q000175:diagnosis / Q000628:therapy*; D004041:Dietary Fats / Q000008:administration & dosage; D004043:Dietary Fiber / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D019468:Disease Management; D004573:Electrolytes / Q000008:administration & dosage; D006801:Humans; D018977:Micronutrients / Q000008:administration & dosage; D018529:Nutritional Support / Q000379:methods*; D011182:Postoperative Care; D011300:Preoperative Care; D014280:Triglycerides / Q000008:administration & dosage; D014947:Wounds and Injuries / Q000150:complications / Q000628:therapy
chemical_list: D004041:Dietary Fats; D004043:Dietary Fiber; D004044:Dietary Proteins; D004573:Electrolytes; D018977:Micronutrients; D014280:Triglycerides
keywords: Chyle leak; Chylothorax; Chylous ascites; Enteral nutrition; Micronutrients; Parenteral nutrition; Thoracic duct