TY - JOUR
T1 - Optimal Fat-Modified Diet Duration for the Treatment of Postoperative Chylothorax in Children
AU - Winder, Melissa M.
AU - Schwartz, Stephanie
AU - Buckley, Jason R.
AU - Fogg, Kristi L.
AU - Matiasek, Megan
AU - Lyman, Alissa
AU - Tortorich, Alisa
AU - Holmes, Kathy
AU - Frank, Deborah U.
AU - Nasworthy, Mandy
AU - Vichayavilas, Piyagarnt E.
AU - Bertrandt, Rebecca A.
AU - Kasmai, Cam
AU - Kuester, Jill C.
AU - Raymond, Tia T.
AU - Greiten, Lawrence E.
AU - Reeder, Ron W.
AU - Bailly, David K.
N1 - Publisher Copyright:
© 2023 The Society of Thoracic Surgeons
PY - 2023
Y1 - 2023
N2 - Background: Dietary modification is the mainstay of treatment for postoperative chylothorax in children. However, optimal fat-modified diet (FMD) duration to prevent recurrence is unknown. Our aim was to determine the association between FMD duration and chylothorax recurrence. Methods: Retrospective cohort study conducted across 6 pediatric cardiac intensive care units within the United States. Patients aged <18 years who developed chylothorax within 30 days after cardiac surgery between January 2020 and April 2022 were included. Patients with a Fontan palliation, who died, or were lost to follow-up or within 30 days of resuming a regular diet were excluded. FMD duration was defined as the first day of a FMD when chest tube output was <10 mL/kg/d without increasing until the resumption of a regular diet. Patients were classified into 3 groups (<3 weeks, 3-5 weeks, >5 weeks) based on FMD duration. Results: A total of 105 patients were included: <3 weeks (n = 61) 3-5 weeks (n = 18), and >5 weeks (n = 26). Demographic, surgical, and hospitalization characteristics were not different across groups. In the >5 weeks group, chest tube duration was longer compared with the <3 weeks and 3-5 weeks groups (median, 17.5 days [interquartile range, 9-31] vs 10 and 10.5 days; P =.04). There was no recurrence of chylothorax within 30 days once chylothorax was resolving regardless of FMD duration. Conclusions: FMD duration was not associated with recurrence of chylothorax, suggesting that FMD duration can safely be shortened to at least <3 weeks from time of resolving chylothorax.
AB - Background: Dietary modification is the mainstay of treatment for postoperative chylothorax in children. However, optimal fat-modified diet (FMD) duration to prevent recurrence is unknown. Our aim was to determine the association between FMD duration and chylothorax recurrence. Methods: Retrospective cohort study conducted across 6 pediatric cardiac intensive care units within the United States. Patients aged <18 years who developed chylothorax within 30 days after cardiac surgery between January 2020 and April 2022 were included. Patients with a Fontan palliation, who died, or were lost to follow-up or within 30 days of resuming a regular diet were excluded. FMD duration was defined as the first day of a FMD when chest tube output was <10 mL/kg/d without increasing until the resumption of a regular diet. Patients were classified into 3 groups (<3 weeks, 3-5 weeks, >5 weeks) based on FMD duration. Results: A total of 105 patients were included: <3 weeks (n = 61) 3-5 weeks (n = 18), and >5 weeks (n = 26). Demographic, surgical, and hospitalization characteristics were not different across groups. In the >5 weeks group, chest tube duration was longer compared with the <3 weeks and 3-5 weeks groups (median, 17.5 days [interquartile range, 9-31] vs 10 and 10.5 days; P =.04). There was no recurrence of chylothorax within 30 days once chylothorax was resolving regardless of FMD duration. Conclusions: FMD duration was not associated with recurrence of chylothorax, suggesting that FMD duration can safely be shortened to at least <3 weeks from time of resolving chylothorax.
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U2 - 10.1016/j.athoracsur.2023.05.021
DO - 10.1016/j.athoracsur.2023.05.021
M3 - Article
C2 - 37308065
AN - SCOPUS:85165000236
SN - 0003-4975
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
ER -