PEDIATRICS Vol. 53 No. 3 March 1974, pp. 400-403
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gershanik, J. J.
Right arrow Articles by Packer, R. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gershanik, J. J.
Right arrow Articles by Packer, R. M.

Dietary Management of Neonatal Chylothorax

Juan J. Gershanik M.D.1, Haldor T. Jonsson Jr. Ph.D.1, Donald A. Riopel M.D.1, and Robert M. Packer B.S.1

1 Departments of Pediatrics and Biochemistry, Medical University of South Carolina, Charleston, and the Department of Pediatrics, Louisiana State University School of Medicine in Shreveport

A neonate with transposition of the great arteries developed chylothorax following ligation of the patent ductus arteriosus. At first, multiple thoracenteses and chest drainage were employed without significant diminution of pleural fluid production. Administration of a formula containing medium chain triglycerides (MCT) was associated with a marked decrease of pleural fluid accumulation within a few days. Total lipid concentration of pleural fluid prior to the diet was 890 mg/100 ml and diminished to 40 mg/100 ml after eight days of administration of the diet. Cholesterol and cholesterol esters decreased from 101 mg/100 ml to 24 mg/100 ml and from 83 mg/100 ml to 9 mg/100 ml, respectively. Total triglyceride concentration fell from 111 mg/100 ml to 2 mg/100 ml. Only negligible amounts of fatty acids with a chain length lower than capric (C10:0) were recovered from the analyses of the samples.

Thereafter, x-ray films revealed no pleural effusion and at the third-month follow-up visit the chest remained clear. The marked diminution in Volume of the pleural effusion in this case is thought to be associated with MCT feedings. MCT passes directly into the portal system, bypassing the lymphatic pathways and still provides adequate caloric intake. Thus, it seems ideal for the treatment of conditions which have a compromised lymphatic drainage. Both clinical data and biochemical findings in this case strongly suggest the use of MCT diet as an important adjunct of the management of neonatal chylothorax.

Submitted on December 6, 1971
Accepted on September 3, 1973




This article has been cited by other articles:


Home page
 ChestHome page
V. Buttiker, S. Fanconi, and R. Burger
Chylothorax in Children: Guidelines for Diagnosis and Management
Chest, September 1, 1999; 116(3): 682 - 687.
[Abstract] [Full Text] [PDF]

Home page
 CLIN PEDIATRHome page
R. P. Dillard and A. G. Stewart
Total Parenteral Nutrition in the Management of Traumatic Chylous Ascites in Infancy
Clinical Pediatrics, May 1, 1985; 24(5): 290 - 292.
[Abstract] [PDF]