Congenital fetal and neonatal visceral chylous effusions: neonatal chylothorax and chylous ascites revisited. A multicenter retrospective study.
Identifieur interne : 004416 ( Main/Exploration ); précédent : 004415; suivant : 004417Congenital fetal and neonatal visceral chylous effusions: neonatal chylothorax and chylous ascites revisited. A multicenter retrospective study.
Auteurs : C. Bellini [Italie] ; Z. Ergaz ; M. Radicioni ; I. Forner-Cordero ; M. Witte ; G. Perotti ; T. Figar ; L. Tubaldi ; P. Camerini ; B. Bar-Oz ; I. Yatsiv ; I. Arad ; F. Traverso ; T. Bellini ; F. Boccardo ; C. Campisi ; P. Dalmonte ; N. Vercellino ; S. Manikanti ; E. BonioliSource :
- Lymphology [ 0024-7766 ] ; 2012.
Descripteurs français
- KwdFr :
- MESH :
- administration et posologie : Triglycéride.
- diagnostic : Ascite chyleuse, Chylothorax.
- usage thérapeutique : Octréotide.
- Ascite chyleuse, Chylothorax, Femelle, Humains, Mâle, Nouveau-né, Études rétrospectives.
English descriptors
- KwdEn :
- MESH :
- chemical , administration & dosage : Triglycerides.
- chemical , therapeutic use : Octreotide.
- congenital : Chylothorax, Chylous Ascites.
- diagnosis : Chylothorax, Chylous Ascites.
- therapy : Chylothorax, Chylous Ascites.
- Female, Humans, Infant, Newborn, Male, Retrospective Studies.
Abstract
This retrospective study was carried out at eight Neonatal Intensive Care Units (NICU) Centers worldwide on 33 newborns presenting at birth with pleural, pericardial, or abdominal chylous effusions. Diagnosis of chylous effusion is based on findings of fluid with a milk-like appearance, a concentration of triglycerides in pleural effusion >1.1 mmol/l, and a total cell count >1,000 cells/ml with a predominance of >80% lymphocytes. Thirty-three newborns met the inclusion criteria and were studied. Six subjects who presented at birth with fetal effusion were treated by in-utero pleuro-amniotic shunt. Five of these patients are alive at follow-up. At birth, pleural drainage was performed in 29/33 patients and abdominal drainage was carried out in 3/33. Total parenteral nutrition (TPN) was given to 32/33 patients; 19/23 patients were fed a medium-chain triglycerides (MCT). No adverse effects were observed. Eight patients were treated with Octreotide at dosages ranging from 1 to 7 mcg/kg/hour for 8 to 35 days. All patients showed decreased chylous production. Two patients were treated by pleurodesis. Twenty-two babies are alive after at least 6 months follow-up, 9/33 are deceased, and 2 were lost to follow-up. Clinical conditions of survivors are basically good except for lung involvement [chronic lung disease (CLD) or lung lymphangiectasia] and lymphedema. All patients were using a MCT diet at follow-up with good control of chylous effusion. Visceral chylous effusions of the fetus and neonate are rare disorders, and there currently is only partial agreement on decision-making strategies. We suggest the need for an international prospective trial in an effort to establish the efficacy and effectiveness of diagnostic and therapeutic options described in this article.
PubMed: 23342929
Affiliations:
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A multicenter retrospective study.</title><author><name sortKey="Bellini, C" sort="Bellini, C" uniqKey="Bellini C" first="C" last="Bellini">C. Bellini</name><affiliation wicri:level="1"><nlm:affiliation>Neonatal Intensive Care Unit, Department of Pediatrics, University of Genoa, IRCCS Gaslini, Genoa, Italy. carlobellini@ospedale-gaslini.ge.it</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Neonatal Intensive Care Unit, Department of Pediatrics, University of Genoa, IRCCS Gaslini, Genoa</wicri:regionArea><wicri:noRegion>Genoa</wicri:noRegion></affiliation></author><author><name sortKey="Ergaz, Z" sort="Ergaz, Z" uniqKey="Ergaz Z" first="Z" last="Ergaz">Z. Ergaz</name></author><author><name sortKey="Radicioni, M" sort="Radicioni, M" uniqKey="Radicioni M" first="M" last="Radicioni">M. Radicioni</name></author><author><name sortKey="Forner Cordero, I" sort="Forner Cordero, I" uniqKey="Forner Cordero I" first="I" last="Forner-Cordero">I. Forner-Cordero</name></author><author><name sortKey="Witte, M" sort="Witte, M" uniqKey="Witte M" first="M" last="Witte">M. Witte</name></author><author><name sortKey="Perotti, G" sort="Perotti, G" uniqKey="Perotti G" first="G" last="Perotti">G. Perotti</name></author><author><name sortKey="Figar, T" sort="Figar, T" uniqKey="Figar T" first="T" last="Figar">T. Figar</name></author><author><name sortKey="Tubaldi, L" sort="Tubaldi, L" uniqKey="Tubaldi L" first="L" last="Tubaldi">L. Tubaldi</name></author><author><name sortKey="Camerini, P" sort="Camerini, P" uniqKey="Camerini P" first="P" last="Camerini">P. Camerini</name></author><author><name sortKey="Bar Oz, B" sort="Bar Oz, B" uniqKey="Bar Oz B" first="B" last="Bar-Oz">B. Bar-Oz</name></author><author><name sortKey="Yatsiv, I" sort="Yatsiv, I" uniqKey="Yatsiv I" first="I" last="Yatsiv">I. Yatsiv</name></author><author><name sortKey="Arad, I" sort="Arad, I" uniqKey="Arad I" first="I" last="Arad">I. Arad</name></author><author><name sortKey="Traverso, F" sort="Traverso, F" uniqKey="Traverso F" first="F" last="Traverso">F. Traverso</name></author><author><name sortKey="Bellini, T" sort="Bellini, T" uniqKey="Bellini T" first="T" last="Bellini">T. Bellini</name></author><author><name sortKey="Boccardo, F" sort="Boccardo, F" uniqKey="Boccardo F" first="F" last="Boccardo">F. Boccardo</name></author><author><name sortKey="Campisi, C" sort="Campisi, C" uniqKey="Campisi C" first="C" last="Campisi">C. Campisi</name></author><author><name sortKey="Dalmonte, P" sort="Dalmonte, P" uniqKey="Dalmonte P" first="P" last="Dalmonte">P. Dalmonte</name></author><author><name sortKey="Vercellino, N" sort="Vercellino, N" uniqKey="Vercellino N" first="N" last="Vercellino">N. Vercellino</name></author><author><name sortKey="Manikanti, S" sort="Manikanti, S" uniqKey="Manikanti S" first="S" last="Manikanti">S. Manikanti</name></author><author><name sortKey="Bonioli, E" sort="Bonioli, E" uniqKey="Bonioli E" first="E" last="Bonioli">E. Bonioli</name></author></analytic><series><title level="j">Lymphology</title><idno type="ISSN">0024-7766</idno><imprint><date when="2012" type="published">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Chylothorax (congenital)</term><term>Chylothorax (diagnosis)</term><term>Chylothorax (therapy)</term><term>Chylous Ascites (congenital)</term><term>Chylous Ascites (diagnosis)</term><term>Chylous Ascites (therapy)</term><term>Female</term><term>Humans</term><term>Infant, Newborn</term><term>Male</term><term>Octreotide (therapeutic use)</term><term>Retrospective Studies</term><term>Triglycerides (administration & dosage)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Ascite chyleuse ()</term><term>Ascite chyleuse (diagnostic)</term><term>Chylothorax ()</term><term>Chylothorax (diagnostic)</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Nouveau-né</term><term>Octréotide (usage thérapeutique)</term><term>Triglycéride (administration et posologie)</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Triglycerides</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Octreotide</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Triglycéride</term></keywords><keywords scheme="MESH" qualifier="congenital" xml:lang="en"><term>Chylothorax</term><term>Chylous Ascites</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Chylothorax</term><term>Chylous Ascites</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Ascite chyleuse</term><term>Chylothorax</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Chylothorax</term><term>Chylous Ascites</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Octréotide</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Female</term><term>Humans</term><term>Infant, Newborn</term><term>Male</term><term>Retrospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Ascite chyleuse</term><term>Chylothorax</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Nouveau-né</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">This retrospective study was carried out at eight Neonatal Intensive Care Units (NICU) Centers worldwide on 33 newborns presenting at birth with pleural, pericardial, or abdominal chylous effusions. Diagnosis of chylous effusion is based on findings of fluid with a milk-like appearance, a concentration of triglycerides in pleural effusion >1.1 mmol/l, and a total cell count >1,000 cells/ml with a predominance of >80% lymphocytes. Thirty-three newborns met the inclusion criteria and were studied. Six subjects who presented at birth with fetal effusion were treated by in-utero pleuro-amniotic shunt. Five of these patients are alive at follow-up. At birth, pleural drainage was performed in 29/33 patients and abdominal drainage was carried out in 3/33. Total parenteral nutrition (TPN) was given to 32/33 patients; 19/23 patients were fed a medium-chain triglycerides (MCT). No adverse effects were observed. Eight patients were treated with Octreotide at dosages ranging from 1 to 7 mcg/kg/hour for 8 to 35 days. All patients showed decreased chylous production. Two patients were treated by pleurodesis. Twenty-two babies are alive after at least 6 months follow-up, 9/33 are deceased, and 2 were lost to follow-up. Clinical conditions of survivors are basically good except for lung involvement [chronic lung disease (CLD) or lung lymphangiectasia] and lymphedema. All patients were using a MCT diet at follow-up with good control of chylous effusion. Visceral chylous effusions of the fetus and neonate are rare disorders, and there currently is only partial agreement on decision-making strategies. We suggest the need for an international prospective trial in an effort to establish the efficacy and effectiveness of diagnostic and therapeutic options described in this article.</div></front></TEI><affiliations><list><country><li>Italie</li></country></list><tree><noCountry><name sortKey="Arad, I" sort="Arad, I" uniqKey="Arad I" first="I" last="Arad">I. Arad</name><name sortKey="Bar Oz, B" sort="Bar Oz, B" uniqKey="Bar Oz B" first="B" last="Bar-Oz">B. Bar-Oz</name><name sortKey="Bellini, T" sort="Bellini, T" uniqKey="Bellini T" first="T" last="Bellini">T. Bellini</name><name sortKey="Boccardo, F" sort="Boccardo, F" uniqKey="Boccardo F" first="F" last="Boccardo">F. Boccardo</name><name sortKey="Bonioli, E" sort="Bonioli, E" uniqKey="Bonioli E" first="E" last="Bonioli">E. Bonioli</name><name sortKey="Camerini, P" sort="Camerini, P" uniqKey="Camerini P" first="P" last="Camerini">P. Camerini</name><name sortKey="Campisi, C" sort="Campisi, C" uniqKey="Campisi C" first="C" last="Campisi">C. Campisi</name><name sortKey="Dalmonte, P" sort="Dalmonte, P" uniqKey="Dalmonte P" first="P" last="Dalmonte">P. Dalmonte</name><name sortKey="Ergaz, Z" sort="Ergaz, Z" uniqKey="Ergaz Z" first="Z" last="Ergaz">Z. Ergaz</name><name sortKey="Figar, T" sort="Figar, T" uniqKey="Figar T" first="T" last="Figar">T. Figar</name><name sortKey="Forner Cordero, I" sort="Forner Cordero, I" uniqKey="Forner Cordero I" first="I" last="Forner-Cordero">I. Forner-Cordero</name><name sortKey="Manikanti, S" sort="Manikanti, S" uniqKey="Manikanti S" first="S" last="Manikanti">S. Manikanti</name><name sortKey="Perotti, G" sort="Perotti, G" uniqKey="Perotti G" first="G" last="Perotti">G. Perotti</name><name sortKey="Radicioni, M" sort="Radicioni, M" uniqKey="Radicioni M" first="M" last="Radicioni">M. Radicioni</name><name sortKey="Traverso, F" sort="Traverso, F" uniqKey="Traverso F" first="F" last="Traverso">F. Traverso</name><name sortKey="Tubaldi, L" sort="Tubaldi, L" uniqKey="Tubaldi L" first="L" last="Tubaldi">L. Tubaldi</name><name sortKey="Vercellino, N" sort="Vercellino, N" uniqKey="Vercellino N" first="N" last="Vercellino">N. Vercellino</name><name sortKey="Witte, M" sort="Witte, M" uniqKey="Witte M" first="M" last="Witte">M. Witte</name><name sortKey="Yatsiv, I" sort="Yatsiv, I" uniqKey="Yatsiv I" first="I" last="Yatsiv">I. Yatsiv</name></noCountry><country name="Italie"><noRegion><name sortKey="Bellini, C" sort="Bellini, C" uniqKey="Bellini C" first="C" last="Bellini">C. Bellini</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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