Nutritional management in patients with chyle leakage: a systematic review

Abstract

Although there is evidence to suggest that nutrition may have a role in the management of patients with chyle leakage, it is not possible to determine which dietary methods are most effective. More research is required before any guidelines for best practice can be established.

Malnutrition and chyle leakage: A life‐threatening duo in heart transplantation post‐Fontan procedure

“…Loss of this protein, fat, fat-soluble vitamins, lymphocytes, immunoglobulins, and electrolyte-rich fluid may result in nutritional deficiencies and prolonged hospitalization that could potentially be fatal if not adequately treated. 7 Although there is evidence to suggest that nutrition should have a role in the management of patients with chyle leakage, it is not known which dietary methods are most effective. 7 The progressive reduction of fat-free and body cellular mass (respectively, 19.5 and 4.8 kg/m) revealed by bioelectrical impedance analysis (BIA) helped our decision-making process.…”

“…7 Although there is evidence to suggest that nutrition should have a role in the management of patients with chyle leakage, it is not known which dietary methods are most effective. 7 The progressive reduction of fat-free and body cellular mass (respectively, 19.5 and 4.8 kg/m) revealed by bioelectrical impedance analysis (BIA) helped our decision-making process. As stated in the literature, 7 long-term conservative therapy may be highly detrimental to the health of the patient.…”

“…7 The progressive reduction of fat-free and body cellular mass (respectively, 19.5 and 4.8 kg/m) revealed by bioelectrical impedance analysis (BIA) helped our decision-making process. As stated in the literature, 7 long-term conservative therapy may be highly detrimental to the health of the patient. Therefore, monitoring the nutritional status is crucial, and short-term nutritional indices, such as prealbumin or cholinesterase, might also be useful to investigate.…”

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

“…The optimal amount of long chain triglyceride fat restriction and percentage of medium chain triglyceride required has never been prospectively studied in a large cohort, and as such the current standard of care is untested in a randomised controlled trial. 1 This is also true of the duration of treatment, with recommendations in the literature of 2 to 6 weeks 6,12,18 reflected in the regional variation in dietary restriction reported by health-care professionals ranging from 2 to 6 weeks of treatment. Given the difficulty of dietary adherence, absence of evidence and known impact on risk of infection, malnutrition, and prolonging hospital stay, these results suggest that a shorter diet treatment duration may be clinically acceptable.…”

“…[9][10][11] The lack of scientific consensus and variation in practice by health-care professionals mean it is unlikely that best patient health outcomes are consistently achieved. 12 The aim of this survey was to characterise variations in practice in the management of chylothorax and identify areas for future research. We hypothesised that considerable variation in the conservative management of chylothorax exists with practice guided by clinician preference and experience rather than evidence-based guidelines.…”