Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center, 17674 Athens, Greece.
Department of Pediatric and Adult Congenital Heart Surgery, Onassis Cardiac Surgery Center, 17674 Athens, Greece.
Nutrients. 2022 Apr 26;14(9):1803. doi: 10.3390/nu14091803.
Postoperative chylothorax is a rare complication following cardiac surgery for congenital heart disease (CHD) in the pediatric population, including neonates and infants. Multiple mechanisms are involved in the development of postoperative chylous effusions, mainly the traumatic injury of lymphatic vessels, systemic venous obstruction and dysfunction of the right ventricle. In this review, we focus on the existing evidence regarding the definition and diagnosis of postoperative chylothorax in children with CHD, as well as current therapeutic approaches, both nutritional and interventional, for the management of these patients. As part of nutritional management, we specifically comment on the use of defatted human milk and its effect on both chylothorax resolution and patient growth. A consensus with regard to several key aspects of this potentially significant complication is warranted given its impact on the cost, morbidity and mortality of children with CHD.
术后乳糜胸是小儿先天性心脏病（CHD）心脏手术后的一种罕见并发症，包括新生儿和婴儿。多种机制参与术后乳糜胸的发生，主要包括淋巴管的创伤性损伤、体静脉阻塞和右心室功能障碍。在这篇综述中，我们重点关注现有关于 CHD 患儿术后乳糜胸的定义和诊断的证据，以及目前针对这些患者的营养和介入治疗方法。作为营养管理的一部分，我们特别评论了脱脂人乳的使用及其对乳糜胸缓解和患者生长的影响。鉴于其对 CHD 患儿的成本、发病率和死亡率的影响，需要就这一潜在严重并发症的几个关键方面达成共识。
