Successful Management of Refractory Chylothorax in Preterm Infants Using Hypertonic Glucose Pleurodesis
Neonatal chylothorax is a potentially fatal respiratory condition caused by a congenital or traumatic etiology. Conventional therapies, such as fasting, total parenteral nutrition, and intravenous octreotide, are generally successful in such cases; however, more invasive therapeutic measures, such a...
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Korean Society of Neonatology
2024-11-01
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| Series: | Neonatal Medicine |
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| Online Access: | http://www.neo-med.org/upload/pdf/nm-2024-31-3-73.pdf |
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| author | Young Seok Do Euiseok Jung Sung Hyeon Park Jeong Min Lee Ha Na Lee Jiyoon Jeong Soo Hyun Kim Byong Sop Lee Ki Soo Kim Ellen Ai-Rhan Kim |
| author_facet | Young Seok Do Euiseok Jung Sung Hyeon Park Jeong Min Lee Ha Na Lee Jiyoon Jeong Soo Hyun Kim Byong Sop Lee Ki Soo Kim Ellen Ai-Rhan Kim |
| author_sort | Young Seok Do |
| collection | DOAJ |
| description | Neonatal chylothorax is a potentially fatal respiratory condition caused by a congenital or traumatic etiology. Conventional therapies, such as fasting, total parenteral nutrition, and intravenous octreotide, are generally successful in such cases; however, more invasive therapeutic measures, such as pleurodesis, should be considered in refractory cases. This case report presents two preterm infants with refractory chylothorax who were non-responsive to conventional treatment but were successfully managed using hypertonic glucose pleurodesis. The first case was that of a female infant born at 24+5 weeks of gestation (585 g) and diagnosed with postsurgical chylothorax at 68 days of life. Even after the initiation of fasting and intravenous octreotide administration, pleural drainage did not reduce. Therefore, the patient underwent three intermittent procedures of 50% glucose pleurodesis, which resulted in the resolution of the chylothorax and subsequent chest tube removal after 37 days. The second case was a female infant born at 34+6 weeks (3,040 g), who was diagnosed with congenital chylothorax immediately after birth. Fasting and intravenous octreotide failed to show any clinical effects; therefore, the patient underwent pleurodesis for 3 consecutive days. After the procedure, the amount of pleural drainage substantially decreased, and the chest tube was removed after 14 days. In both cases, a temporal relation between pleurodesis and chylothorax resolution was observed, suggesting that hypertonic glucose pleurodesis may be an effective and safe alternative for treating refractory chylothorax in preterm infants with minimal side effects. Further studies are needed to establish the optimal protocol for this procedure and to compare its efficacy with that of other pleurodesis agents. |
| format | Article |
| id | doaj-art-e79635bbf4a54f69b0828e25084ecd5d |
| institution | OA Journals |
| issn | 2287-9412 2287-9803 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Korean Society of Neonatology |
| record_format | Article |
| series | Neonatal Medicine |
| spelling | doaj-art-e79635bbf4a54f69b0828e25084ecd5d2025-08-20T02:38:25ZengKorean Society of NeonatologyNeonatal Medicine2287-94122287-98032024-11-01313737910.5385/nm.2024.31.3.731102Successful Management of Refractory Chylothorax in Preterm Infants Using Hypertonic Glucose PleurodesisYoung Seok Do0Euiseok Jung1Sung Hyeon Park2Jeong Min Lee3Ha Na Lee4Jiyoon Jeong5Soo Hyun Kim6Byong Sop Lee7Ki Soo Kim8Ellen Ai-Rhan Kim9 Department of Pediatrics, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea Division of Neonatology, Department of Pediatrics, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea Division of Neonatology, Department of Pediatrics, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea Division of Neonatology, Department of Pediatrics, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea Division of Neonatology, Department of Pediatrics, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea Division of Neonatology, Department of Pediatrics, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea Division of Neonatology, Department of Pediatrics, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea Division of Neonatology, Department of Pediatrics, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, KoreaNeonatal chylothorax is a potentially fatal respiratory condition caused by a congenital or traumatic etiology. Conventional therapies, such as fasting, total parenteral nutrition, and intravenous octreotide, are generally successful in such cases; however, more invasive therapeutic measures, such as pleurodesis, should be considered in refractory cases. This case report presents two preterm infants with refractory chylothorax who were non-responsive to conventional treatment but were successfully managed using hypertonic glucose pleurodesis. The first case was that of a female infant born at 24+5 weeks of gestation (585 g) and diagnosed with postsurgical chylothorax at 68 days of life. Even after the initiation of fasting and intravenous octreotide administration, pleural drainage did not reduce. Therefore, the patient underwent three intermittent procedures of 50% glucose pleurodesis, which resulted in the resolution of the chylothorax and subsequent chest tube removal after 37 days. The second case was a female infant born at 34+6 weeks (3,040 g), who was diagnosed with congenital chylothorax immediately after birth. Fasting and intravenous octreotide failed to show any clinical effects; therefore, the patient underwent pleurodesis for 3 consecutive days. After the procedure, the amount of pleural drainage substantially decreased, and the chest tube was removed after 14 days. In both cases, a temporal relation between pleurodesis and chylothorax resolution was observed, suggesting that hypertonic glucose pleurodesis may be an effective and safe alternative for treating refractory chylothorax in preterm infants with minimal side effects. Further studies are needed to establish the optimal protocol for this procedure and to compare its efficacy with that of other pleurodesis agents.http://www.neo-med.org/upload/pdf/nm-2024-31-3-73.pdfchylothoraxpleurodesisglucose solution, hypertonic |
| spellingShingle | Young Seok Do Euiseok Jung Sung Hyeon Park Jeong Min Lee Ha Na Lee Jiyoon Jeong Soo Hyun Kim Byong Sop Lee Ki Soo Kim Ellen Ai-Rhan Kim Successful Management of Refractory Chylothorax in Preterm Infants Using Hypertonic Glucose Pleurodesis Neonatal Medicine chylothorax pleurodesis glucose solution, hypertonic |
| title | Successful Management of Refractory Chylothorax in Preterm Infants Using Hypertonic Glucose Pleurodesis |
| title_full | Successful Management of Refractory Chylothorax in Preterm Infants Using Hypertonic Glucose Pleurodesis |
| title_fullStr | Successful Management of Refractory Chylothorax in Preterm Infants Using Hypertonic Glucose Pleurodesis |
| title_full_unstemmed | Successful Management of Refractory Chylothorax in Preterm Infants Using Hypertonic Glucose Pleurodesis |
| title_short | Successful Management of Refractory Chylothorax in Preterm Infants Using Hypertonic Glucose Pleurodesis |
| title_sort | successful management of refractory chylothorax in preterm infants using hypertonic glucose pleurodesis |
| topic | chylothorax pleurodesis glucose solution, hypertonic |
| url | http://www.neo-med.org/upload/pdf/nm-2024-31-3-73.pdf |
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