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Pneumothorax and Chylothorax

  • Sebastiano Cacciaguerra
  • Pieralba Catalano
  • Enrica Antonelli
  • Salvatore Arena
Chapter

Abstract

Respiratory distress is a common presenting feature among newborns. Thorough clinical assessment and prompt investigation are required to ensure correct treatment and improve outcomes. Pneumothorax (PTX) is the most common of the air-leak disorders in neonates and is more frequently observed in low birth weight infants. Although it is one of the few treatable causes of respiratory distress in neonatal age, it is life-threatening and is associated with an increased risk of mortality and morbidity. Incidence increases in patients with concurrent lung disease or requiring mechanical ventilation. Furthermore, neonatal PTX can develop due to high transpulmonary pressure, generated at the onset of respiration. Chylothorax is rarer, but it represents the most frequent cause of pleural effusion in the neonatal period. Clinical features depend on the amount of chyle collected in the pleural space, ranging from asymptomatic to life-threatening conditions, requiring urgent treatment. Prognosis is much better when chylothorax is diagnosed after birth than when discovered in utero, because during fetal life pleural effusion can act as a space-occupying mass resulting in pulmonary hypoplasia.

References

  1. 1.
    Bruschettini M, Romantsik O, Ramenghi LA, et al. Needle aspiration versus intercostal tube drainage for pneumothorax in the newborn. Cochrane Database Syst Rev. 2016;(1):CD011724.  https://doi.org/10.1002/14651858.CD011724.pub2.
  2. 2.
    Apiliogullari B, Sunam GS, Ceran S, et al. Evaluation of neonatal pneumothorax. J Int Med Res. 2011;39:2436–40.CrossRefPubMedGoogle Scholar
  3. 3.
    Litmanovitz I, Carlo WA. Expectant management of pneumothorax in ventilated neonates. Pediatrics. 2008;122:e975–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Stoll BJ, Kliegman RM. Extrapulmonary extravasation of air. In: Behrman RE, Kliegman RM, Jenson HB, editors. Nelson textbook of pediatrics. 17th ed. Philadelphia: WB Saunders; 2004. p. 586–7.Google Scholar
  5. 5.
    Bhatia R, Davis PG, Doyle LW, et al. Identification of pneumothorax in very preterm infants. J Pediatr. 2011;159(1):115–120.e1.CrossRefPubMedGoogle Scholar
  6. 6.
    Walker MW, Shoemaker M, Riddle K, et al. Clinical process improvement: reduction of pneumothorax and mortality in high-risk preterm infants. J Perinatol. 2002;22:641–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Seguier-Lipszyc E, Elizur A, Klin B, et al. Management of primary spontaneous pneumothorax in children. Clin Pediatr (Phila). 2011;50:797–802.CrossRefGoogle Scholar
  8. 8.
    Duong HH, Mirea L, Shah PS, et al. Pneumothorax in neonates: trends, predictors and outcomes. J Neonatal Perinatal Med. 2014;7:29–38.PubMedGoogle Scholar
  9. 9.
    Currie GP, Alluri R, Christie GL, et al. Pneumothorax: an update. Postgrad Med J. 2007;83:461–5.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Sharma A, Jindal P. Principles of diagnosis and management of traumatic pneumothorax. J Emerg Trauma Shock. 2008;1:34–41.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Cizmeci MN, Kanburoglu MK, Akelma AZ, et al. An abrupt increment in the respiratory rate is a sign of neonatal pneumothorax. J Matern Fetal Neonatal Med. 2015;28:583–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Madansky DL, Lawson EE, Chernick V, et al. Pneumothorax and other forms of pulmonary air leak in newborns. Am Rev Respir Dis. 1979;120:729–37.PubMedGoogle Scholar
  13. 13.
    Primhak RA. Factors associated with pulmonary air leak in premature infants receiving mechanical ventilation. J Pediatr. 1983;102:764–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Esme H, Doğru O, Eren S, et al. The factors affecting persistent pneumothorax and mortality in neonatal pneumothorax. Turk J Pediatr. 2008;50:242–6.PubMedGoogle Scholar
  15. 15.
    Miller JD, Carlo WA. Pulmonary complications of mechanical ventilation in neonates. Clin Perinatol. 2008;35:273–81.CrossRefPubMedGoogle Scholar
  16. 16.
    Klinger G, Ish-Hurwitz S, Osovsky M, et al. Risk factors for pneumothorax in very low birth weight infants. Pediatr Crit Care Med. 2008;9:398–402.CrossRefPubMedGoogle Scholar
  17. 17.
    Morley CJ, Davis PG, Doyle LW, et al. COIN trial investigators. Nasal CPAP or intubation at birth for very preterm infants. N Engl J Med. 2008;358(7):700–8.CrossRefPubMedGoogle Scholar
  18. 18.
    SUPPORT Study Group of the Eunice Kennedy Shriver NICHD Neonatal Research Network, Finer NN, Carlo WA, Walsh MC, et al. Early CPAP versus surfactant in extremely preterm infants. N Engl J Med. 2010;362(21):1970–9.CrossRefPubMedCentralGoogle Scholar
  19. 19.
    Ngerncham S, Kittiratsatcha P, Pacharn P. Risk factors of pneumothorax during the first 24 hours of life. J Med Assoc Thail. 2005;88:S135–41.Google Scholar
  20. 20.
    Zanardo V, Padovani E, Pittini C, et al. The influence of timing of elective cesarean section on risk of neonatal pneumothorax. J Pediatr. 2007;150(3):252–5.CrossRefPubMedGoogle Scholar
  21. 21.
    Boo NY, Cheah IG, Malaysian National Neonatal Registry. Risk factors associated with pneumothorax in Malaysian neonatal intensive care units. J Paediatr Child Health. 2011;47:183–90.CrossRefPubMedGoogle Scholar
  22. 22.
    Benterud T, Sandvik L, Lindemann R. Cesarean section is associated with more frequent pneumothorax and respiratory problems in the neonate. Acta Obstet Gynecol Scand. 2009;88:359–61.CrossRefPubMedGoogle Scholar
  23. 23.
    McIntosh N, Becher JC, Cunningham S, et al. Clinical diagnosis of pneumothorax is late: use of trend data and decision support might allow preclinical detection. Pediatr Res. 2000;48:408–15.CrossRefPubMedGoogle Scholar
  24. 24.
    O’Connor AR, Morgan WE. Radiological review of pneumothorax. BMJ. 2005;330:1493–7.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Tocino I, Miller MH. Computed tomography in blunt chest trauma. J Thorac Imaging. 1987;2:45–59.CrossRefPubMedGoogle Scholar
  26. 26.
    Liu J, Chi JH, Ren XL, et al. Lung ultrasonography to diagnose pneumothorax of the newborn. Am J Emerg Med. 2017;35:1298–302.CrossRefPubMedGoogle Scholar
  27. 27.
    Husain LF, Hagopian L, Wayman D, et al. Sonographic diagnosis of pneumothorax. J Emerg Trauma Shock. 2012;5:76–81.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    De Luca C, Valentino M, Rimondi MR, et al. Use of chest sonography in acute-care radiology. J Ultrasound. 2008;11:125–34.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Murphy M, Nagdev A, Sisson C. Lack of lung sliding on ultrasound does not always indicate a pneumothorax. Resuscitation. 2008;77(2):270.CrossRefPubMedGoogle Scholar
  30. 30.
    Ball CG, Kirkpatrick AW, Feliciano DV. The occult pneumothorax: what have we learned? Can J Surg. 2009;52:E173–9.PubMedPubMedCentralGoogle Scholar
  31. 31.
    Blaivas M, Lyon M, Duggal S. A prospective comparison of supine chest radiography and bedside ultrasound for the diagnosis of traumatic pneumothorax. Acad Emerg Med. 2005;12:844–9.CrossRefPubMedGoogle Scholar
  32. 32.
    Lichtenstein DA, Menu Y. A bedside ultrasound sign ruling out pneumothorax in the critically ill. Lung sliding. Chest. 1995;108:1345–8.CrossRefPubMedGoogle Scholar
  33. 33.
    Lichtenstein DA, Mezière G, Lascols N, et al. Ultrasound diagnosis of occult pneumothorax. Crit Care Med. 2005;33:1231–8.CrossRefPubMedGoogle Scholar
  34. 34.
    Lichtenstein D, Mezière G, Biderman P, et al. The comet-tail artifact: an ultrasound sign ruling out pneumothorax. Intensive Care Med. 1999;25:383–8.CrossRefPubMedGoogle Scholar
  35. 35.
    Soldati G, Testa A. Pignataro G et al. The ultrasonographic deep sulcus sign in traumatic pneumothorax. Ultrasound Med Biol. 2006;32:1157–63.CrossRefPubMedGoogle Scholar
  36. 36.
    Lichtenstein D, Mezière G, Biderman P, et al. The "lung point": an ultrasound sign specific to pneumothorax. Intensive Care Med. 2000;26:1434–40.CrossRefPubMedGoogle Scholar
  37. 37.
    Parekh UR, Maguire AM, Emery J, et al. Pneumothorax in neonates: complication during endotracheal intubation, diagnosis, and management. J Anaesthesiol Clin Pharmacol. 2016;32:397–9.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Katar S, Devecioğlu C, Kervancioğlu M, et al. Symptomatic spontaneous pneumothorax in term newborns. Pediatr Surg Int. 2006;22:755–8.CrossRefPubMedGoogle Scholar
  39. 39.
    Cloherty JP, Eichenwald EC, Stark AR. Pulmonary air leak. Manual of neonatal care. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2011.Google Scholar
  40. 40.
    Trevisanuto D, Doglioni N, Ferrarese P, et al. Neonatal pneumothorax: comparison between neonatal transfers and inborn infants. J Perinat Med. 2005;33:449–54.CrossRefPubMedGoogle Scholar
  41. 41.
    Ilçe Z, Gündogdu G, Kara C, et al. Which patients are at risk? Evaluation of the morbility and mortality in newborn pneumothorax. Indian Pediatr. 2003;40:325–8.PubMedGoogle Scholar
  42. 42.
    Ainsworth AP, Ruager AR. Holtved Neonatal pneumothorax. Ugerskr Laeger. 2000;162:6679–82.Google Scholar
  43. 43.
    Vibede L, Vibede E, Bendtsen M, et al. Neonatal pneumothorax: a descriptive regional Danish study. Neonatology. 2017;111:303–8.CrossRefPubMedGoogle Scholar
  44. 44.
    Powers WF, Clemens JD. Prognostic implications of age at detection of air leak in very low birth weight infants requiring ventilatory support. J Pediatr. 1993;123:611–7.CrossRefPubMedGoogle Scholar
  45. 45.
    Hill A, Perlman JM, Volpe JJ. Relationship of pneumothorax to occurrence of intraventricular hemorrhage in the premature newborn. Pediatrics. 1982;69:144–9.PubMedGoogle Scholar
  46. 46.
    Soto-Martine M, Massie J. Chylothorax: diagnosis and management in children. Paediatr Respir Rev. 2009;10:199–207.CrossRefGoogle Scholar
  47. 47.
    van Straaten HL, Gerards LJ, Krediet TG. Chylothorax in the neonatal period. Eur J Pediatr. 1993;152:2–5.CrossRefPubMedGoogle Scholar
  48. 48.
    Rocha G, Fernandes P, Rocha P, Quintas C, Martins T, Proença E. Pleural effusions in the neonate. Acta Paediatr. 2006;95:791–8.CrossRefPubMedGoogle Scholar
  49. 49.
    Long WA, Lawson EE, Harned HS Jr, Kraybill EN. Pleural effusion in the first days of life: a prospective study. Am J Perinatol. 1984;1:190–4.CrossRefPubMedGoogle Scholar
  50. 50.
    Ergaz Z, Bar-Oz B, Yatsiv I, Arad I. Congenital chylothorax: clinical course and prognostic significance. Pediatr Pulmonol. 2009;44:806–11.CrossRefPubMedGoogle Scholar
  51. 51.
    Downie L, Sasi A, Malhotra A. Congenital chylothorax: associations and neonatal outcomes. J Paediatr Child Health. 2014;50:234–8.CrossRefPubMedGoogle Scholar
  52. 52.
    Bessone LN, Ferguson TB, Burford TH. Chylothorax: collective review. Ann Thorac Surg. 1971;12:527–50.CrossRefPubMedGoogle Scholar
  53. 53.
    Vain NE, Swarner OW, Cha CC. Neonatal chylothorax. A report and discussion of nine consecutive cases. J Pediatr Surg. 1980;15:261–5.CrossRefPubMedGoogle Scholar
  54. 54.
    Rustico MA, Lanna M, Coviello D, Smoleniec J, Nicolini U. Fetal pleural effusion. Prenat Diagn. 2007;27:793–9.CrossRefPubMedGoogle Scholar
  55. 55.
    Deurloo KL, Devlieger R, Lopriore E, Klumper FJ, Oepkes D. Isolated fetal hydrothorax with hydrops: a systematic review of prenatal treatment options. Prenat Diagn. 2007;27:893–9.CrossRefPubMedGoogle Scholar
  56. 56.
    Lee CJ, Tsao PN, Chen CY, Hsieh WS, Liou JY, Chou HC. Prenatal therapy improves the survival of premature infants with congenital chylothorax. Pediatr Neonatol. 2016;57:127–32.CrossRefPubMedGoogle Scholar
  57. 57.
    Butler MG, Isogal S, Weinstein BM. Lymphatic development. Birth Defects Res C Embryo Today. 2009;87:222–31.CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Sabin FR. The origin and development of the lymphatic system. Johns Hopkins Hospital Rep. 1916;17:347–440.Google Scholar
  59. 59.
    McKendry JBJ, Lindsey WK, Gerstein MC. Congenital defects of the lymphatics in infancy. Pediatrics. 1957;19:21.PubMedGoogle Scholar
  60. 60.
    Jr MJL. Diagnosis and management of chylothorax. Chest Surg Clin N Am. 1996;6:139–48.Google Scholar
  61. 61.
    Sassoon CS, Light RW. Chylothorax and pseudochylothorax. Clin Chest Med. 1985;6:163–71.PubMedGoogle Scholar
  62. 62.
    Harvey JG, Houlsby W, Sherman K, Gough MH. Congenital chylothorax: report of a unique case associated with ‘H’-type tracheo-oesophageal fistula. Br J Surg. 1979;46:485–7.CrossRefGoogle Scholar
  63. 63.
    Williams KR, Burford TH. The management of chylothorax. Ann Surg. 1964;160:131–40.CrossRefPubMedPubMedCentralGoogle Scholar
  64. 64.
    Curci MR, Debbins AW. Bilateral chylothorax in a newborn. J Pediatr Surg. 1980;15:663–5.CrossRefPubMedGoogle Scholar
  65. 65.
    Wasmuth-Pietzuch A, Hansmann M, Bartmann P, Heep A. Congenital chylothorax: lymphopenia and high risk of neonatal infections. Acta Paediatr. 2004;93:220–4.CrossRefPubMedGoogle Scholar
  66. 66.
    Bialkowski A, Poets CF, Franz AR. Erhebungseinheit fur seltene padiatrische Erkrankungen in Deutschland Study Group. Congenital chylothorax: a prospective nationwide epidemiological study in Germany. Arch Dis Child Fetal Neonatal Ed. 2015;100:F169–72.CrossRefPubMedGoogle Scholar
  67. 67.
    Rocha G. Pleural effusions in the neonate. Curr Opin Pulm Med. 2007;13:305–11.CrossRefPubMedGoogle Scholar
  68. 68.
    Waller K, Chaithongwongwatthana S, Yamasmit W, Donnenfeld AE. Chromosomal abnormalities among 246 fetuses with pleural effusions detected on prenatal ultrasound examination; factors associated with an increased risk of aneuploidy. Genet Med. 2005;7:417–21.CrossRefPubMedGoogle Scholar
  69. 69.
    Morphis IG, Arcinne EL, Krause JR. Generalized lymphangioma in infants with chylothorax. Pediatrics. 1970;46:566–75.PubMedGoogle Scholar
  70. 70.
    Dunkelman H, Sharief N, Berman L, Ninan T. Generalised lymphangiomatosis with chylothorax. Arch Dis Child. 1989;64:1058–60.CrossRefPubMedPubMedCentralGoogle Scholar
  71. 71.
    Thomas HM, Shaw NJ, Weindling AM. Generalized lymphangiomatosis with chylothorax. Arch Dis Child. 1990;65:334.CrossRefPubMedPubMedCentralGoogle Scholar
  72. 72.
    Noonan J, Walter LR, Reeves JT. Congenital pulmonary lymphangiectasis. Am J Dis Child. 1970;120:314–9.PubMedGoogle Scholar
  73. 73.
    Moerman P, Vandenberghe K, Devlieger H, Van Hole C, Fryns JP, Lauweryns JM. Congenital pulmonary lymphangiectasis with chylothorax: a heterogeneous lymphatic vessel abnormality. Am J Med Genet. 1993;47:54–8.CrossRefPubMedGoogle Scholar
  74. 74.
    Hunter W, Becroft D. Congenital pulmonary lymphangiectasis associated with pleural effusions. Arch Dis Child. 1984;59:278–9.CrossRefPubMedPubMedCentralGoogle Scholar
  75. 75.
    Browse NL, Allen DR, Wilson NM. Management of chylothorax. Br J Surg. 1997;84:1711–6.CrossRefPubMedGoogle Scholar
  76. 76.
    Van Aerde J, Campbell AN, Smyth JA, Lloyd D, Bryan MH. Spontaneous chylothorax in newborns. Am J Dis Child. 1984;138:961–4.PubMedGoogle Scholar
  77. 77.
    Picone O, Benachi A, Mandelbrot L, Ruano R, Dumez Y, Dommergues M. Thoracoamniotic shunting for fetal pleural effusions with hydrps. Am J Obstet Gynecol. 2004;191:2047–50.CrossRefPubMedGoogle Scholar
  78. 78.
    Mussat P, Dommergues M, Parat S, et al. Congenital chylothorax with hydrops: postnatal care and outcome following antenatal diagnosis. Acta Pediatr. 1995;84:749–55.CrossRefGoogle Scholar
  79. 79.
    Weber AM, Philipson EH. Fetal pleural effusion: a review and meta-analysis for prognostic indicators. Obstet Gynecol. 1992;79:281–6.PubMedGoogle Scholar
  80. 80.
    Easa D, Balaraman V, Ash K, Thompson B, Boychuk R. Congenital chylothorax and mediastinal neuroblastoma. J Pediatr Surg. 1991;26:96–8.CrossRefPubMedGoogle Scholar
  81. 81.
    Ibrahim H, Asamoah A, Krouskop RW, Lewis D, Webster P, Pramanik AK. Congenital chylothorax in neonatal thyrotoxicosis. J Perinatol. 1999;19:68–71.CrossRefPubMedGoogle Scholar
  82. 82.
    Chan SY, Lau W, Wong WH, Cheng LC, Chau AK, Cheung YF. Chylothorax in children after congenital heart surgery. Ann Thorac Surg. 2006;82:1650–6.CrossRefPubMedGoogle Scholar
  83. 83.
    Zuluaga MT. Chylothorax after surgery for congenital heart disease. Curr Opin Pediatr. 2012;24:291–4.CrossRefPubMedGoogle Scholar
  84. 84.
    Naik S, Greenough A, Zhang YX, Davenport M. Prediction of morbidity during infancy after repair of congenital diaphragmatic hernia. J Pediatr Surg. 1996;31:1651–4.CrossRefPubMedGoogle Scholar
  85. 85.
    Cevese PG, Vecchioni R, D’Amico DF, et al. Postoperative chylothorax. Six cases in 2,500 operations, with a survey of the worl literature. J Thorac Cardiovasc Surg. 1975;69:966–71.PubMedGoogle Scholar
  86. 86.
    Kramer SS, Taylor GA, Garfinkel DJ, Simmons MA. Lethal chylothoraces due to superior vena caval thrombosis in infants. AJR. 1981;137:559–63.CrossRefPubMedGoogle Scholar
  87. 87.
    Ruggieto RP, Caruso G. Chylothorax – a complication of subclavian vein catheterization. J Parenter Enter Nutr. 1985;9:750–3.CrossRefGoogle Scholar
  88. 88.
    Kumar SP, Belik J. Chylothorax—a complication of chest tube placement in a neonate. Crit Care Med. 1984;12:411–2.CrossRefPubMedGoogle Scholar
  89. 89.
    Wilson-Storey D, MacKinlay GA. Thoraco-abdominal birth injury—presentation, diagnosis and management in an unusual case. Scott Med J. 1987;32:89–90.CrossRefPubMedGoogle Scholar
  90. 90.
    Ichikawa Y, Sato A, Sato K, et al. Chylothorax associated with child abuse. Pediatr Int. 2015;57:1202–4.CrossRefPubMedGoogle Scholar
  91. 91.
    Anderst JD. Chylothorax and child abuse. Pediatr Crit Care Med. 2007;8:394–6.PubMedGoogle Scholar
  92. 92.
    Tutor JD. Chylothorax in infants and children. Pediatrics. 2014;133:722–33.CrossRefPubMedGoogle Scholar
  93. 93.
    Chernick V, Reed MH. Pneumothorax and chylothorax in the neonatal period. J Pediatr. 1970;76:624–32.CrossRefPubMedGoogle Scholar
  94. 94.
    Yang J, Codreanu I, Zhuang H. Minimal lymphatic leakage in an infant with chylothorax detected by lymphoscintigraphy SPECT/CT. Pediatrics. 2014;134:e606–10.CrossRefPubMedGoogle Scholar
  95. 95.
    Lopez-Gutierrez JC, Tovar JA. Chylothorax and chylous ascites: management and pitfalls. Semin Pediatr Surg. 2014;23:298–302.CrossRefPubMedGoogle Scholar
  96. 96.
    Beghetti M, La Scala G, Belli D, Bugmann P, Kalangos A, Le Coultre C. Etiology and management of pediatric chylothorax. J Pediatr. 2000;136:653–8.CrossRefPubMedGoogle Scholar
  97. 97.
    Büttiker V, Fanconi S, Burger R. Chylothorax in children: guidelines for diagnosis and management. Chest. 1999;116:682–7.CrossRefPubMedGoogle Scholar
  98. 98.
    Clark ME, Woo RK, Johnson SM. Thoracoscopic pleural clipping for the management of congenital chylothorax. Pediatr Surg Int. 2015;31:1133–7.CrossRefPubMedGoogle Scholar
  99. 99.
    Dubin PJ, Kind IN, Gallagher PG. Congenital chylothorax. Curr Opin Pediatr. 2000;12:505–9.CrossRefPubMedGoogle Scholar
  100. 100.
    Cormack BE, Wilson NJ, Finucane K, West TM. Use of monogen for pediatric postoperative chylothorax. Ann Thorac Surg. 2004;77:301–5.CrossRefPubMedGoogle Scholar
  101. 101.
    Rasiah SV, Oei J, Lui K. Octreotide in the treatment of congenital chylothorax. J Paediatr Child Health. 2004;40:585–8.CrossRefPubMedGoogle Scholar
  102. 102.
    Helin RD, Angeles ST, Bhat R. Octreotide therapy for chylothorax in infants and children: a brief review. Pediatr Crit Care Med. 2006;7:576–9.CrossRefPubMedGoogle Scholar
  103. 103.
    Horvers M, Mooij CF, Antonius TA. Is octreotide treatment useful in patients with congenital chylothorax? Neonatology. 2012;101:225–31.CrossRefPubMedGoogle Scholar
  104. 104.
    Shah D, Sinn JK. Octreotide as therapeutic option for congenital idiopathic chylothorax: a case series. Acta Paediatr. 2012;101:e151–5.CrossRefPubMedGoogle Scholar
  105. 105.
    Das A, Shah PS. Octreotide for the treatment of chylothorax in neonates. Cochrane Database Syst Rev. 2010:CD006388.  https://doi.org/10.1002/14651858.CD006388.pub2.
  106. 106.
    Roehr CC, Jung A, Proquitté H, et al. Somatostatin or octreotide as treatment options for chylothorax in young children: a systematic review. Intensive Care Med. 2006;32:650–7.CrossRefPubMedGoogle Scholar
  107. 107.
    Yin R, Zhang R, Wang J, et al. Effects of somatostatin/octreotide treatment in neonates with congenital chylothorax. Medicine. 2017;96(29):e7594.CrossRefPubMedPubMedCentralGoogle Scholar
  108. 108.
    Church JT, Antunez AG, Dean A, et al. Evidence-based management of chylothorax in infants. J Pediatr Surg. 2017;52:907–12.CrossRefPubMedGoogle Scholar
  109. 109.
    Berkenbosch JW, Withington DE. Management of postoperative chylothorax with nitric oxide: a case report. Crit Care Med. 1999;27:1022–4.CrossRefPubMedGoogle Scholar
  110. 110.
    Oh JH, Lee G, Lee JH. Congenital chylothorax and pulmonary hypertension complicated with heart failure and hepatopathy. Pediatr Int. 2013;55:e7–10.CrossRefPubMedGoogle Scholar
  111. 111.
    Malleske DT, Yoder BA. Congenital chylothorax treated with oral sildenafil: a case report and review of the literature. J Perinatol. 2015;35:384–6.CrossRefPubMedGoogle Scholar
  112. 112.
    Nguyen D, Tchervenkov CI. Successful management of postoperative chylothorax with fibrin glue in a premature neonate. Can J Surg. 1994;37:158.PubMedGoogle Scholar
  113. 113.
    Rifai N, Sfeir R, Rakza T, et al. Successful management of severe chylothorax with argon plasma fulguration and fibrin glue in a premature infant. Eur J Pediatr Surg. 2003;13:324–6.CrossRefPubMedGoogle Scholar
  114. 114.
    Slater BJ, Rothenberg SS. Thoracoscopic thoracic duct ligation for congenital and acquired disease. J Laparoendosc Adv Surg Tech A. 2015;25:605–7.CrossRefPubMedGoogle Scholar
  115. 115.
    Wolff AB, Silen ML, Kokoska ER, Rodgers BM. Treatment of refractory chylothorax with externalized pleuroperitoneal shunts in children. Ann Thorac Surg. 1999;68:1053–7.CrossRefPubMedGoogle Scholar
  116. 116.
    Engum SA, Rescorla FJ, West KW, Scherer LR 3rd, Grosfeld JL. The use of pleuroperitoneal shunts in the management of persistent chylothorax in infants. J Pediatr Surg. 1999;34:286–90.CrossRefPubMedGoogle Scholar
  117. 117.
    Utture A, Kodur V, Mondkar J. Chemical pleurodesis with oxytetracycline in congenital chylothorax. Indian Pediatr. 2016;53:1105–6.PubMedGoogle Scholar
  118. 118.
    Matsukuma E, Aoki Y, Sakai M, et al. Treatment with OK-432 for persistent congenital chylothorax in newborn infants resistant to octreotide. J Pediatr Surg. 2009;44:e37–9.CrossRefPubMedGoogle Scholar
  119. 119.
    Chen M, Chen CP, Shih JC, et al. Antenatal treatment of chylothorax and cystic hygroma with OK-432 in nonimmune hydrops fetalis. Fetal Diagn Ther. 2005;20:309–15.CrossRefPubMedGoogle Scholar
  120. 120.
    Scottoni F, Fusaro F, Conforti A, Morini F, Bagolan P. Pleurodesis with povidone-iodine for refractory chylothorax in newborns: personal experience and literature review. J Pediatr Surg. 2015;50:1722–5.CrossRefPubMedGoogle Scholar
  121. 121.
    Al-Tawil K, Ahmed G, Al-Hathal M, Al-Jarallah Y, Campbell N. Congenital chylothorax. Am J Perinatol. 2000;17:121–6.CrossRefPubMedGoogle Scholar
  122. 122.
    Platis IE, Nwogu CE. Chylothorax. Thorac Surg Clin. 2006;16:546–9.Google Scholar
  123. 123.
    Cope C. Management of chylothorax via percutaneous embolization. Curr Opin Pulm Med. 2004;10:311–4.CrossRefPubMedGoogle Scholar
  124. 124.
    Itkin M, Krishnamurthy G, Naim MY, Bird GL, Keller MS. Percutaneous thoracic duct embolization as a treatment for intrathoracic chyle leaks in infants. Pediatrics. 2011;128:e237–41.CrossRefPubMedGoogle Scholar
  125. 125.
    Majdalany BS, Saad WA, Chick JFB, Khaja MS, Cooper KJ, Srinivasa RN. Pediatric Lymphangiography, thoracic duct embolization and thoracic duct disruption: a single-institution experience in 11 children with chylothorax. Pediatr Radiol. 2018;48:235–40.CrossRefPubMedGoogle Scholar
  126. 126.
    Shih YT, Su PH, Chen JY, Lee IC, Hu JM, Chang HP. Common etiologies of neonatal pleural effusion. Pediatr Neonatol. 2011;52:251–5.CrossRefPubMedGoogle Scholar
  127. 127.
    Ruano R, Ramalho AS, Cardoso AK, Moise K Jr, Zugaib M. Prenatal diagnosis and natural history of fetuses presenting with pleural effusion. Prenat Diagn. 2011;31:496–9.CrossRefPubMedGoogle Scholar
  128. 128.
    Derderian SC, Trivedi S, Farrell J, et al. Outcomes of fetal intervention for primary hydrothorax. J Pediatr Surg. 2014;49:900–3; discussion 903–904.Google Scholar
  129. 129.
    Mallmann MR, Graham V, Rosing B, et al. Thoracoamniotic shunting for fetal hydrothorax: predictors of intrauterine course and postnatal outcome. Fetal Diagn Ther. 2017;41:58–65.CrossRefPubMedGoogle Scholar
  130. 130.
    Yang YS, Ma GC, Shih JC, et al. Experimental treatment of bilateral fetal chylothorax using in-utero pleurodesis. Ultrasound Obstet Gynecol. 2012;39:56–62.CrossRefPubMedGoogle Scholar
  131. 131.
    Yinon Y, Kelly E, Ryan G. Fetal pleural effusions. Best Pract Res Clin Obstet Gynaecol. 2008;22:77–96.CrossRefPubMedGoogle Scholar
  132. 132.
    Peranteau WH, Adzick NS, Boelig MM, et al. Thoracoamniotic shunts for the management of fetal lung lesions and pleural effusions: a single-institution review and predictors of survival in 75 cases. J Pediatr Surg. 2015;50:301–5.CrossRefPubMedGoogle Scholar
  133. 133.
    Mon RA, Treadwell MC, Berman DR, et al. Outcomes of fetuses with primary hydrothorax that undergo prenatal intervention (prenatal intervention for hydrothorax). J Surg Res. 2018;221:121–7.CrossRefPubMedGoogle Scholar
  134. 134.
    Merchant AM, Peranteau W, Wilson RD, et al. Postnatal chest wall deformities after feal thoracoamniotic shunting for congenital cystic adenomatoid malformation. Fetal Diagn Ther. 2007;22:435–9.CrossRefPubMedPubMedCentralGoogle Scholar
  135. 135.
    Dorsi M, Giuseppi A, Lesage F, et al. Prenatal factors associated with neonatal survival of infants with congenital chylothorax. J Perinatol. 2018;38:31–4.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Sebastiano Cacciaguerra
    • 1
  • Pieralba Catalano
    • 1
  • Enrica Antonelli
    • 2
  • Salvatore Arena
    • 2
  1. 1.Department of Paediatric SurgeryA.R.N.A.S. GaribaldiCataniaItaly
  2. 2.Department of Paediatric SurgeryUniversity of MessinaMessinaItaly

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