A novel therapeutic for refractory chylothorax

Douglas Z. Liou; Heather Warren; Dermot P. Maher; Harmik J. Soukiasian; Nicolas Melo; Ali Salim; Eric J. Ley

doi:10.1378/chest.12-3081

A novel therapeutic for refractory chylothorax

Douglas Z. Liou, Heather Warren, Dermot P. Maher, Harmik J. Soukiasian, Nicolas Melo, Ali Salim, Eric J. Ley

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

Thoracic duct injury is a rare but serious complication following surgery of the neck or chest that leads to uncontrolled chyle leak. Conventional management includes drainage, nutritional modifi cation, or aggressive surgical interventions such as thoracic duct ligation, fl ap coverage, fi brin glue, or talc pleurodesis; few successful medical therapeutics are available. We report a case of a high-output chylothorax refractory to aggressive medical and surgical interventions. Chyle output decreased substantially after initiating midodrine, an α1-adrenergic agonist that causes vasoconstriction of the lymph system, reducing chyle fl ow. This case report suggests that midodrine may be a novel therapeutic for refractory chyle leaks.

Original language	English (US)
Pages (from-to)	1055-1057
Number of pages	3
Journal	CHEST
Volume	144
Issue number	3
DOIs	https://doi.org/10.1378/chest.12-3081
State	Published - Sep 2013
Externally published	Yes

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine
Cardiology and Cardiovascular Medicine

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10.1378/chest.12-3081

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title = "A novel therapeutic for refractory chylothorax",

abstract = "Thoracic duct injury is a rare but serious complication following surgery of the neck or chest that leads to uncontrolled chyle leak. Conventional management includes drainage, nutritional modifi cation, or aggressive surgical interventions such as thoracic duct ligation, fl ap coverage, fi brin glue, or talc pleurodesis; few successful medical therapeutics are available. We report a case of a high-output chylothorax refractory to aggressive medical and surgical interventions. Chyle output decreased substantially after initiating midodrine, an α1-adrenergic agonist that causes vasoconstriction of the lymph system, reducing chyle fl ow. This case report suggests that midodrine may be a novel therapeutic for refractory chyle leaks.",

author = "Liou, {Douglas Z.} and Heather Warren and Maher, {Dermot P.} and Soukiasian, {Harmik J.} and Nicolas Melo and Ali Salim and Ley, {Eric J.}",

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T1 - A novel therapeutic for refractory chylothorax

AU - Liou, Douglas Z.

AU - Warren, Heather

AU - Maher, Dermot P.

AU - Soukiasian, Harmik J.

AU - Melo, Nicolas

AU - Salim, Ali

AU - Ley, Eric J.

PY - 2013/9

Y1 - 2013/9

N2 - Thoracic duct injury is a rare but serious complication following surgery of the neck or chest that leads to uncontrolled chyle leak. Conventional management includes drainage, nutritional modifi cation, or aggressive surgical interventions such as thoracic duct ligation, fl ap coverage, fi brin glue, or talc pleurodesis; few successful medical therapeutics are available. We report a case of a high-output chylothorax refractory to aggressive medical and surgical interventions. Chyle output decreased substantially after initiating midodrine, an α1-adrenergic agonist that causes vasoconstriction of the lymph system, reducing chyle fl ow. This case report suggests that midodrine may be a novel therapeutic for refractory chyle leaks.

AB - Thoracic duct injury is a rare but serious complication following surgery of the neck or chest that leads to uncontrolled chyle leak. Conventional management includes drainage, nutritional modifi cation, or aggressive surgical interventions such as thoracic duct ligation, fl ap coverage, fi brin glue, or talc pleurodesis; few successful medical therapeutics are available. We report a case of a high-output chylothorax refractory to aggressive medical and surgical interventions. Chyle output decreased substantially after initiating midodrine, an α1-adrenergic agonist that causes vasoconstriction of the lymph system, reducing chyle fl ow. This case report suggests that midodrine may be a novel therapeutic for refractory chyle leaks.

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A novel therapeutic for refractory chylothorax

Abstract

ASJC Scopus subject areas

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