Enliven: Pediatrics and Neonatal Biology

Introduction Neonatal chylothorax results from the accumulation of chyle in the pleural spaceand may be either a congenital or an acquired condition. Objectives To determine the etiology, clinical course and responseto treatment of neonatal chylothorax. Methods Retrospective observational study of all newborns with the discharge diagnosis of chylothorax between 2000 and 2015 in a tertiary neonatal intensive care unit. Results Seven cases of chylothorax were reported and all were preterm (gestational age 32-36 weeks):four congenital and three traumatic. One case of congenital chylothorax was idiopathic and the others were associated with hydropsfetalis (n=1), Noonan Syndrome (n=1) and Trisomy 21 (n=1).Traumatic chylothorax occurred after surgical repair of congenital diaphragmatic hernia (n=2) and esophageal atresia (n=1). Treatment consisted of pleural taps, total parental nutrition, and respiratory support as required. Four cases who did not respond to total parental nutrition were successfully treated with continuous infusion of octreotide. Resolution time of chylothorax ranged between 15 and 86 days.Two newborns died. Conclusion Clinical outcome of chylothorax is generaly good but etiology seems to be decisive in the evolution, with more prolonged course and associated morbility in congenital cases. Octreotide seems to be an important adjuvant treatment among the conservative strategies and appear to have a good safety profile in newborn. More studies are still necessary to investigate all aspects of octreotide treatment to determine the amount of its dose, initiation time and treatment duration