{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:46:29Z","timestamp":1780098389715,"version":"3.54.0"},"reference-count":38,"publisher":"Springer Publishing Company","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neonatal Network"],"published-print":{"date-parts":[[2021,11,1]]},"abstract":"<jats:p>Chylothorax, a lymphatic flow disorder characterized by an abnormal circulation of lymph fluid into the pleural cavity, is the most common cause of pleural effusions during the neonatal period. This condition affects 1\/15,000 neonates every year. Affected neonates often manifest with respiratory distress, electrolyte imbalances, sepsis, and even immunodeficiencies. Mortality risk is highest among neonates undergoing cardiac surgery as well as those with associated hydrops fetalis. Conservative treatment options include bowel rest with administration of parenteral nutrition, followed with medium-chain triglyceride enteral feedings, and octreotide therapy. Severe or persistent cases require surgical intervention. This can involve a unilateral or bilateral pleurectomy and thoracic duct ligation, with or without pleurodesis. Early identification and successful treatment of this condition is contingent upon awareness of the most current evidence and a timely cross-disciplinary approach to care.<\/jats:p>","DOI":"10.1891\/11-t-705","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T15:50:15Z","timestamp":1638201015000},"page":"386-392","source":"Crossref","is-referenced-by-count":10,"title":["Chylothorax: A Stepwise Approach to Diagnosis and Treatment"],"prefix":"10.1891","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2010-4320","authenticated-orcid":true,"given":"Shaniquewa","family":"Jackson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy J.","family":"Jnah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"793","published-online":{"date-parts":[[2021,11,29]]},"reference":[{"key":"2021112907501062000_40.6.386.1","doi-asserted-by":"crossref","unstructured":"Prentice B , Jaff\u00e9 A . Air and fluid in the pleural space. In Kendig's Disorders of the Respiratory Tract in Children . 9th ed. Philadelphia, PA: Elsevier; 2018: 1007\u20131026.","DOI":"10.1016\/B978-0-323-44887-1.00069-9"},{"key":"2021112907501062000_40.6.386.2","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.rmed.2019.08.014","article-title":"Clinical approach and review of causes of a chylothorax","volume":"157","year":"2019","journal-title":"Respir Med"},{"key":"2021112907501062000_40.6.386.3","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.jss.2020.07.005","article-title":"Efficacy of early pleurectomy for severe congenital chylothorax","volume":"256","year":"2020","journal-title":"J Surg Res"},{"issue":"4","key":"2021112907501062000_40.6.386.4","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.siny.2017.03.005","article-title":"Congenital chylothorax","volume":"22","year":"2017","journal-title":"Semin Fetal Neonatal Med"},{"key":"2021112907501062000_40.6.386.5","doi-asserted-by":"publisher","DOI":"10.1891\/0730-0832.38.6.357"},{"key":"2021112907501062000_40.6.386.6","doi-asserted-by":"publisher","DOI":"10.1891\/0730-0832.25.5.371"},{"issue":"3","key":"2021112907501062000_40.6.386.7","first-page":"A405","article-title":"P639 management of congenital chylothorax in intensive neonatal care unit in Sfax (Tunisia)","volume":"104","year":"2019","journal-title":"Arch Dis Childhood"},{"key":"2021112907501062000_40.6.386.8","unstructured":"Rudrappa M , Paul M . Chylothorax. In: StatPearls . Treasure Island, FL: StatPearls Publishing; 2020."},{"key":"2021112907501062000_40.6.386.9","unstructured":"Winnie GB ., Haider SK , Vemana AP , Lossef SV . Chylothorax. In: Nelson Textbook of Pediatrics . 21st ed., pp.). Philadelphia, PA: Elsevier; 2020: 2323\u20132324."},{"key":"2021112907501062000_40.6.386.10","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-006-0114-9"},{"issue":"8","key":"2021112907501062000_40.6.386.11","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1111\/jpc.13889","article-title":"Octreotide for congenital and acquired chylothorax in newborns: A systematic review","volume":"54","year":"2018","journal-title":"Journal of Paediatrics and Child Health"},{"key":"2021112907501062000_40.6.386.12","doi-asserted-by":"crossref","unstructured":"Schild HH , Strassburg CP , Welz A , Kalff J Treatment options in patients with chylothorax. Deutsches Aerzteblatt Online .14(9):1\u20136. https:\/\/doi.org\/10.3238\/arztebl.2013.0819","DOI":"10.3238\/arztebl.2013.0819"},{"key":"2021112907501062000_40.6.386.13","unstructured":"Holcomb GW , Murphy JP , Peter S D Acquired lesions of the lung and pleura. In: Holcomb and Ashcraft's Pediatric Surgery . 7th ed. Philadelphia, PA: Elsevier; 368\u2013370."},{"issue":"1","key":"2021112907501062000_40.6.386.14","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1002\/ped4.12007","article-title":"Management and outcomes of congenital chylothorax in the neonatal intensive care unit: A case series","volume":"1","year":"2017","journal-title":"Pediat Invest"},{"key":"2021112907501062000_40.6.386.15","first-page":"53","article-title":"Congenital chylothorax: Current perspectives and trends","volume":"7","year":"2017","journal-title":"Res Rep Neonatol"},{"key":"2021112907501062000_40.6.386.16","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-2072"},{"issue":"2","key":"2021112907501062000_40.6.386.17","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1097\/ANC.0000000000000257","article-title":"Congenital chylothorax","volume":"16","year":"2016","journal-title":"Adv Neonatal Care"},{"issue":"4","key":"2021112907501062000_40.6.386.18","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.prrv.2009.06.008","article-title":"Chylothorax: Diagnosis and management in children","volume":"10","year":"2009","journal-title":"Paediat Respirat Rev"},{"key":"2021112907501062000_40.6.386.19","unstructured":"Crowley MA . Neonatal respiratory disorders. In: Fanaroff and Martin's Neonatal-Perinatal Medicine E-book: Diseases of the Fetus and Infant . 11th ed. Philadelphia, PA: Elsevier Health Sciences; 2019: 1208\u20131209."},{"issue":"3","key":"2021112907501062000_40.6.386.20","doi-asserted-by":"crossref","first-page":"e2020011601","DOI":"10.1542\/peds.2020-011601","article-title":"Congenital chylothorax and hydrops fetalis: A novel neonatal presentation of RASA1 mutation","volume":"147","year":"2021","journal-title":"Pediatrics (Evanston)"},{"issue":"7","key":"2021112907501062000_40.6.386.21","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1007\/s12098-019-02908-5","article-title":"Congenital Chylothorax in a neonate with Cornelia de Lange syndrome: A rare complication managed with a novel indigenously prepared milk formulation","volume":"86","year":"2019","journal-title":"Indian J Pediatr"},{"issue":"3","key":"2021112907501062000_40.6.386.22","first-page":"91","article-title":"Congenital fetal and neonatal visceral chylous effusions: Neonatal chylothorax and chylous ascites revisited. A multicenter retrospective study","volume":"45","year":"2012","journal-title":"Lymphology"},{"key":"2021112907501062000_40.6.386.23","doi-asserted-by":"publisher","DOI":"10.1097\/MCP.0b013e328338dde2"},{"key":"2021112907501062000_40.6.386.24","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2014.09.011"},{"issue":"3","key":"2021112907501062000_40.6.386.25","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1038\/s41372-020-00771-3","article-title":"Neonatal lymphatic flow disorders: Impact of lymphatic imaging and interventions on outcomes","volume":"41","year":"2021","journal-title":"J Perinatol"},{"key":"2021112907501062000_40.6.386.26","doi-asserted-by":"publisher","DOI":"10.1378\/chest.116.3.682"},{"key":"2021112907501062000_40.6.386.27","unstructured":"McCray S , Parrish C . When chyle leaks: Nutrition management options. Pract Gastroenterol 2004:60\u201376."},{"issue":"6","key":"2021112907501062000_40.6.386.28","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1007\/s00246-016-1393-8","article-title":"Feasibility and efficacy of defatted human milk in the treatment for chylothorax after cardiac surgery in infants","volume":"37","year":"2016","journal-title":"Pediatric Cardiol"},{"key":"2021112907501062000_40.6.386.29","doi-asserted-by":"publisher","DOI":"10.1177\/0148607114566464"},{"issue":"5","key":"2021112907501062000_40.6.386.30","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1177\/0884533617722762","article-title":"Immunoglobulin A and protein content of low-fat human milk prepared for the treatment of chylothorax","volume":"33","year":"2018","journal-title":"Nutr Clin Pract"},{"issue":"5","key":"2021112907501062000_40.6.386.31","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1002\/jpen.1722","article-title":"Human milk retains important immunologic properties after defatting","volume":"44","year":"2020","journal-title":"JPEN"},{"issue":"3","key":"2021112907501062000_40.6.386.32","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s40268-018-0237-9","article-title":"Octreotide use in neonates: A case series","volume":"18","year":"2018","journal-title":"Drugs R&D"},{"key":"2021112907501062000_40.6.386.33","doi-asserted-by":"crossref","unstructured":"Shetty SK , Butler M . Pleural effusion in a neonate. BMJ Case Rep . 2011;1\u20134. https:\/\/doi.org\/10.1136\/bcr.03.2011.4008","DOI":"10.1136\/bcr.03.2011.4008"},{"issue":"1","key":"2021112907501062000_40.6.386.34","first-page":"122","article-title":"Should newborns with refractory chylothorax be tried on higher dose of octreotide?","volume":"118","year":"2021","journal-title":"Neonatology (Basel, Switzerland)"},{"issue":"3","key":"2021112907501062000_40.6.386.35","doi-asserted-by":"crossref","first-page":"205","DOI":"10.4103\/jcn.JCN_42_17","article-title":"Congenital idiopathic chylothorax: A very rare case","volume":"6","year":"2017","journal-title":"J Clin Neonatol"},{"key":"2021112907501062000_40.6.386.36","unstructured":"Eichenwald E , Hansen A , Martin C , Stark A . Appendix A. In: Cloherty and Stark's Manual of Neonatal Care . 8th ed. Philadelphia, PA: Wolters Kluwer; 2017; 1390."},{"issue":"7","key":"2021112907501062000_40.6.386.37","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1016\/j.jpedsurg.2018.05.008","article-title":"Analysis of the etiology and treatment of chylothorax in 119 pediatric patients in a single clinical center","volume":"54","year":"2019","journal-title":"J Pediatr Surg"},{"key":"2021112907501062000_40.6.386.38","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedneo.2011.06.002"}],"container-title":["Neonatal Network"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1891\/11-T-705","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T17:15:15Z","timestamp":1673889315000},"score":1,"resource":{"primary":{"URL":"http:\/\/connect.springerpub.com\/lookup\/doi\/10.1891\/11-T-705"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,1]]},"references-count":38,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,11,29]]},"published-print":{"date-parts":[[2021,11,1]]}},"alternative-id":["10.1891\/11-T-705"],"URL":"https:\/\/doi.org\/10.1891\/11-t-705","relation":{},"ISSN":["0730-0832","1539-2880"],"issn-type":[{"value":"0730-0832","type":"print"},{"value":"1539-2880","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,1]]}}}