Deng Qin, Pan Zhengxia, Kong Lin, Gong Min, Gao Zhongmin, Liu Yongfang
Department of Clinical Nutrition Children's Hospital of Chongqing Medical University, National Clinical Re-search Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Chongqing, China.
Department of Cardiovascular Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.
Asia Pac J Clin Nutr. 2025 Apr;34(2):202-207. doi: 10.6133/apjcn.202504_34(2).0007.
Previous studies on the risk factors for prolonged pleural effusion (PPE) have primarily focused on surgical-related risk factors, with little research exploring the influence of nutritional factors on this delay. This study aimed to identify the nutritional risk factors for PPE in Chinese infants following congenital heart disease (CHD) surgery.
We retrospectively reviewed the medical records of patients under 3 years old with chylothorax following CHD surgery from 2016 to 2020. PPE was defined as pleural effusion lasting over 14 days. Logistical regression analysis was conducted to identify the risk factors.
Of 136 patients, 42 patients developed PPE (30.9%). The PPE group had lower Height-for-Age Z-scores (HAZ) compared to the non-PPE group, while other demographic factors were not significantly different. Univariate analysis revealed that patients in PPE group exhibited delayed onset of chylothorax, prolonged duration of mechanical ventilation, increased chest effusion volume on the first postoperative day, and a reduced proportion of energy intake from enteral nutrition (EN) during the stable phase. Variables with p-value of <0.1 in univariate logistic regression analysis were included in the multivariate logistic regression analysis. A delayed onset of chylothorax, extended periods of mechanical ventilation, a lower HAZ and a reduced proportion of energy intake from EN during the recovery phase.
A delayed onset of chylothorax, extended periods of mechanical ventilation, a lower HAZ, and a reduced proportion of energy intake from EN during the recovery phase predict a higher risk of PPE.
既往关于胸腔积液持续时间延长（PPE）危险因素的研究主要集中在手术相关危险因素，很少有研究探讨营养因素对这种延迟的影响。本研究旨在确定中国先天性心脏病（CHD）手术后婴儿发生PPE的营养危险因素。
我们回顾性分析了2016年至2020年3岁以下CHD手术后发生乳糜胸患者的病历。PPE定义为胸腔积液持续超过14天。进行逻辑回归分析以确定危险因素。
136例患者中，42例发生PPE（30.9%）。与非PPE组相比，PPE组的年龄别身高Z评分（HAZ）较低，而其他人口统计学因素无显著差异。单因素分析显示，PPE组患者乳糜胸发病延迟、机械通气时间延长、术后第1天胸腔积液量增加以及稳定期肠内营养（EN）能量摄入比例降低。单因素逻辑回归分析中p值<0.1的变量纳入多因素逻辑回归分析。乳糜胸发病延迟、机械通气时间延长、HAZ较低以及恢复阶段EN能量摄入比例降低。
乳糜胸发病延迟、机械通气时间延长、HAZ较低以及恢复阶段EN能量摄入比例降低预示着发生PPE的风险较高。
