An international survey of the nutrition management of chylothorax: a time for change

Although chylothorax is an uncommon complication following paediatric cardiothoracic surgery, it has significant associated morbidities and increased in-hospital mortality, as well as results in higher costs. A lack of prospective evidence or consensus guidelines for management of chylothorax furthe...

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Bibliographic Details
Published in:Cardiology in the young 2019-09, Vol.29 (9), p.1127-1136
Main Authors: Marino, L. V., Bell, K. L., Woodgate, J., Doolan, A.
Format: Article
Language:English
Subjects:
Breastfeeding & lactation
Cardiac Surgical Procedures - adverse effects
Cardiology
Cardiovascular disease
Child
Child, Preschool
Chylothorax - epidemiology
Chylothorax - therapy
Clinical medicine
Congenital diseases
Consent
Conservative Treatment - methods
Cross-Sectional Studies
Diet
Diet, Fat-Restricted - methods
Dietitians
Disease Management
Domains
Fatty acids
Global Health
Health
Heart surgery
Hospitals
Humans
Identification methods
Infant
Intensive care
Lipids
Malnutrition
Management
Medical personnel
Metabolism
Morbidity
Morbidity - trends
Mortality
Nutrition
Nutrition research
Nutrition Surveys - methods
Original Article
Parenteral nutrition
Pediatrics
Physicians
Polls & surveys
Postoperative Complications
Practice Guidelines as Topic
Professionals
Prospective Studies
Therapy
Triglycerides
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Summary:Although chylothorax is an uncommon complication following paediatric cardiothoracic surgery, it has significant associated morbidities and increased in-hospital mortality, as well as results in higher costs. A lack of prospective evidence or consensus guidelines for management of chylothorax further hinders optimal management. The aim of this survey was to characterise variations in practice in the management of chylothorax and to identify areas for future research. A descriptive, observational survey investigating conservative management practices of chylothorax was distributed internationally to health-care professionals in paediatric intensive care and cardiology units. The survey investigated five domains: the first providing general information about health-care professionals and four domains focusing on clinical practice including diet composition and duration. In total, sixty-four health-care professionals completed the survey, representing 38 organisations from 16 countries. The respondents were dietitians (80%), physicians (19%), and nurses (1%). In Australia and New Zealand, management was most commonly directed by physicians' preference (67%) as compared to unit protocols in Europe (67%), United States of America (67%), and Other regions (55%). Dietitians in Australia/New Zealand, United Kingdom, and Ireland followed the most restrictive diet therapy recommending
ISSN:1047-9511
1467-1107
DOI:10.1017/S1047951119001525