{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T23:20:02Z","timestamp":1787700002919,"version":"build-2784847793"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,4,9]],"date-time":"2022-04-09T00:00:00Z","timestamp":1649462400000},"content-version":"vor","delay-in-days":98,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim was to assess the therapeutic strategy of patients with chylothorax in a neonatal intensive care unit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010eight infants with chylothorax were included in this study. Their clinical characteristics and outcomes were reviewed retrospectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The male\u2010to\u2010female ratio was 1:1. The mean gestational age and birthweight were 35.1 \u00b1 3.5\u2009weeks and 2,692 \u00b1 791\u2009g, respectively. Eighteen patients were diagnosed with congenital chylothorax; chylothorax occurred postoperatively in 10 patients. Chromosomal anomalies were diagnosed in 8 patients. Six patients received surgical therapy, such as pleurodesis, thoracic duct ligation, or lymphaticovenous anastomosis. Two patients required surgery due to resistance to pleurodesis. In surgically managed patients, the daily maximum amount of pleural effusion (mL)\/bodyweight (kg) ratio was significantly larger than in non\u2010surgically managed patients: 229.0 \u00b1 180.5 versus 59.7 \u00b1 49.2\u2009mL\/kg. In the receiver operating characteristic analysis of the daily maximum amount of pleural effusion\/bodyweight ratio, the area under the curve was 0.889 when the cut\u2010off value was 101\u2009mL\/kg, and the sensitivity was 0.8333 and the specificity was 0.8095 (<jats:italic>P<\/jats:italic> = 0.0059).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pleurodesis using OK432 could become a surgical first\u2010line therapy for chylothorax even for neonates. It was important to initiate pleurodesis for refractory chylothorax at an earlier stage. A daily chylous effusion\/bodyweight ratio of &gt;101\u2009mL\/kg was a good predictor and seemed to be a useful parameter for prompt surgical intervention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.15043","type":"journal-article","created":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T18:15:48Z","timestamp":1635358548000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Management of refractory chylothorax in the neonatal intensive care unit: A 22\u2010year experience"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3034-693X","authenticated-orcid":false,"given":"Yoshiaki","family":"Takahashi","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery Niigata University Graduate School of Medical and Dental Sciences Niigata City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Kinoshita","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Niigata University Graduate School of Medical and Dental Sciences Niigata City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Niigata University Graduate School of Medical and Dental Sciences Niigata City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhki","family":"Arai","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Niigata University Graduate School of Medical and Dental Sciences Niigata City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyuki","family":"Ohyama","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Niigata University Graduate School of Medical and Dental Sciences Niigata City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Yokota","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Niigata University Graduate School of Medical and Dental Sciences Niigata City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Niigata University Graduate School of Medical and Dental Sciences Niigata City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Sugai","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Niigata University Graduate School of Medical and Dental Sciences Niigata City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoichi","family":"Takano","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Niigata University Graduate School of Medical and Dental Sciences Niigata City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.12477"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/3903598"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.13889"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2018.06.032"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2009.08.010"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2018.05.008"},{"issue":"1","key":"e_1_2_8_8_1","first-page":"1","article-title":"Should newborns with refractory chylothorax be tried on higher dose of octreotide?","volume":"25","author":"Vass G","year":"2021","journal-title":"Neonatology"},{"issue":"9","key":"e_1_2_8_9_1","first-page":"CD006388","article-title":"Octreotide for the treatment of chylothorax in neonates","author":"Das A","year":"2010","journal-title":"Cochrane Database Syst. 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