Dietary management of neonatal chylothorax
Gershanik, J.J.; Jonsson, H.T.; Riopel, D.A.; Packer, R.M.
Pediatrics 53(3): 400-403
1974
ISSN/ISBN: 0031-4005 PMID: 4815260 Document Number: 77972
A Caucasian boy with cyanotic congenital heart disease underwent ligation of the patent ductus arteriosus at 11 days old. After 8 days chylothorax was diagnosed. The chylous fluid was drained during 5 days and then multiple thoracenteses were begun. Fluid accumulation continued and 18 days after operation a diet containing medium-chain triglycerides (MCT) was begun. During the following week pleural effusion decreased and the fluid composition changed. After 16 days of treatment a regular infant formula was given and no pleural effusion was noted. At the start of the MCT diet, 45 ml of milky fluid with a total lipid concentration of 890 mg/100 ml was aspirated. After 8 days of treatment with the formula diet 7 ml of fluid with 40 mg/100 ml total lipid was aspirated. The fatty acid composition of the fluid showed a notable decrease in the longer chain fatty acids to their lowest values after 3.5 days of MCT treatment. Total protein of the fluid remained fairly constant throughout treatment, varying from 2.5 to 2.9 g/100 ml. Cholesterol and cholesteryl esters decreased from 101 and 83 mg/100 ml to 24.7 and 8.7, total fatty acids from 101 to 2 and total triglycerides from 111 to 2 mg/100 ml during the 8 days of treatment.