Nutritional management of postoperative chylothorax in children with CHD

Cardiol Young. 2023 Sep;33(9):1663-1671. doi: 10.1017/S1047951122003109. Epub 2022 Sep 30.

Abstract

Introduction: Chylothorax after congenital cardiac surgery is associated with increased risk of malnutrition. Nutritional management following chylothorax diagnosis varies across sites and patient populations, and a standardised approach has not been disseminated. The aim of this review article is to provide contemporary recommendations related to nutritional management of chylothorax to minimise risk of malnutrition.

Methods: The management guidelines were developed by consensus across four dietitians, one nurse practitioner, and two physicians with a cumulative 52 years of experience caring for children with CHD. A PubMed database search for relevant literature included the terms chylothorax, paediatric, postoperative, CHD, chylothorax management, growth failure, and malnutrition.

Results: Fat-modified diets and nil per os therapies for all paediatric patients (<18 years of age) following cardiac surgery are highlighted in this review. Specific emphasis on strategies for treatment, duration of therapies, optimisation of nutrition including nutrition-focused lab monitoring, and supplementation strategies are provided.

Conclusions: Our deliverable is a clinically useful guide for the nutritional management of chylothorax following paediatric cardiac surgery.

Keywords: CHD; Chylothorax; chylothorax management; growth failure; malnutrition; paediatric; postoperative.

Publication types

  • Review

MeSH terms

  • Cardiac Surgical Procedures* / adverse effects
  • Child
  • Chylothorax* / diagnosis
  • Chylothorax* / etiology
  • Chylothorax* / therapy
  • Heart Defects, Congenital* / complications
  • Heart Defects, Congenital* / surgery
  • Humans
  • Infant
  • Malnutrition* / complications
  • Nutritional Status
  • Postoperative Complications / etiology