Chylothorax is defined as triglycerides more than 113 mg/dl
(1.24 mmol/L) in pleural cavity.
number of therapeutic interventions have been used to reduce chyle production
and promote resolution of a chylothorax. Initial management typically includes
restriction or temporary cessation of enteral feedings. Enteral feedings high in
medium-chain triglycerides (MCT), or parenteral nutrition may be used. Total
parenteral nutrition typically results in resolution in 75 to 80% of cases by
that time. In resistant cases, pleurodesis, ligation of the thoracic duct, or
placement of drains and pleuroperitoneal shunts may be considered.
Octreotide has become
another option for management of patients with chylothorax. Although the exact
mechanism by which the drug exerts its effects has not been defined, it is
believed that the multiple effects of octreotide on the gastrointestinal tract
and the reduction in splanchnic blood flow reduce thoracic duct flow and
decrease the triglyceride content of