Successful Management of Chylothorax With Etilefrine: Case Report in 2 Pediatric Patients

Pediatrics. 2018 May;141(5):e20163309. doi: 10.1542/peds.2016-3309.

Abstract

Chylothorax is defined as the accumulation of chyle within the pleural space. Originally described in 1917 by Pisek, it is the most common cause of pleural effusion in the neonatal period. The leading cause of chylothorax is laceration of the thoracic duct during surgery, which occurs in 0.85% to 6.6% of children undergoing cardiothoracic surgery. Few authors of reports in the literature have looked at etilefrine, a relatively unknown sympathomimetic, as an option for the medical treatment of chylothorax. In this case report, we review the clinical course of 2 infants with type III esophageal atresia who developed chylothorax after thoracic surgery and were successfully treated with intravenous etilefrine after failing initial dietary and pharmacological management.

Publication types

  • Case Reports

MeSH terms

  • Chylothorax / drug therapy*
  • Chylothorax / etiology
  • Esophageal Atresia / surgery*
  • Etilefrine / administration & dosage
  • Etilefrine / therapeutic use*
  • Female
  • Humans
  • Infant, Newborn
  • Infusions, Intravenous
  • Male
  • Postoperative Complications / drug therapy
  • Sympathomimetics / administration & dosage
  • Sympathomimetics / therapeutic use*
  • Thoracic Surgical Procedures / adverse effects*
  • Tracheoesophageal Fistula / surgery*

Substances

  • Sympathomimetics
  • Etilefrine

Supplementary concepts

  • Esophageal atresia with or without tracheoesophageal fistula