Chylothorax after repair of congenital diaphragmatic hernia--risk factors and morbidity. 1998

V Kavvadia, and A Greenough, and M Davenport, and J Karani, and K H Nicolaides
Children Nationwide Regional Neonatal Intensive Care Unit, Department of Child Health, King's College Hospital, London, England.

OBJECTIVE Chylothoraces have been reported rarely after congenital diaphragmatic hernia (CDH) repair, but that is contrary to the authors' experience. The aim of this study was to audit the outcome of antenatally diagnosed CDH cases to determine the incidence, possible risk factors, and morbidity associated with chylothorax in CDH patents. METHODS Twenty-four of 35 consecutive infants with CDH (69%) underwent surgical repair and survived the immediate postoperative period. RESULTS Effusions developed in all 22 for whom chest radiographs were available. Six of the eight infants whose effusions required drainage had a chylothorax. Those six infants required a mean of 8 days of thoracentesis, during which a mean total volume of 358 mL/kg of fluid was removed. The infants remained on a medium-chain triglyceride (MCT) formula for a mean of 81 days. The six infants with a chylothorax differed from the rest with respect to their duration of oxygen dependence (a median of 28.5 versus 15 days, P < .05) and hospital stay (a median of 5.5 versus 4 weeks, P < .05), but no significant risk factors for the development of a chylothorax were identified. CONCLUSIONS Chylothorax is a relatively common cause of effusion after CDH repair and is associated with increased morbidity.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008297 Male Males
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D002916 Chylothorax The presence of chyle in the thoracic cavity. (Dorland, 27th ed)
D005260 Female Females
D006548 Hernia, Diaphragmatic Protrusion of abdominal structures into the THORAX as a result of congenital or traumatic defects in the respiratory DIAPHRAGM. Diaphragmatic Hernia,Diaphragmatic Hernias,Hernias, Diaphragmatic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D065630 Hernias, Diaphragmatic, Congenital Protrusion of abdominal structures into the THORAX as a result of embryologic defects in the DIAPHRAGM often present in the neonatal period. It can be isolated, syndromic, non-syndromic or be a part of chromosome abnormality. Associated pulmonary hypoplasia and PULMONARY HYPERTENSION can further complicate stabilization and surgical intervention. Bochdalek Hernia,Congenital Diaphragmatic Hernia,Congenital Diaphragmatic Hernias,Morgagni Hernia,Morgagni's Hernia,Agenesis of Hemidiaphragm,Bochdalek Hernias,Congenital Diaphragmatic Defect,Morgagni Hernias,Morgagni's Hernias,Unilateral Agenesis of Diaphragm,Congenital Diaphragmatic Defects,Defect, Congenital Diaphragmatic,Defects, Congenital Diaphragmatic,Diaphragm Unilateral Ageneses,Diaphragm Unilateral Agenesis,Diaphragmatic Defect, Congenital,Diaphragmatic Defects, Congenital,Diaphragmatic Hernia, Congenital,Diaphragmatic Hernias, Congenital,Hemidiaphragm Ageneses,Hemidiaphragm Agenesis,Hernia, Bochdalek,Hernia, Congenital Diaphragmatic,Hernia, Morgagni,Hernia, Morgagni's,Hernias, Bochdalek,Hernias, Congenital Diaphragmatic,Hernias, Morgagni,Hernias, Morgagni's,Morgagnis Hernia,Morgagnis Hernias

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