Common Etiologies of Neonatal Pleural Effusion

doi:10.1016/j.pedneo.2011.06.002

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Title:	Common Etiologies of Neonatal Pleural Effusion
Authors:	Shih, Yueh-Ting Chen, Jia-Yuh Su, Pen-Hua Lee, Inn-Chi Hu, Jui-Ming Chang, Hua-Pin
Contributors:	中山醫學大學
Keywords:	chylothorax;empyema;hydrops fetalis;neonate;pleural effusion
Date:	2011
Issue Date:	2015-05-25T09:57:27Z (UTC)
ISSN:	1875-9572
Abstract:	Background Pleural effusion is rare and includes several disease entities in the neonatal period. The aim of this study was to investigate the etiology, management, and outcome of neonatal pleural effusions. Methods We retrospectively collected all neonates who were admitted to the neonatal intensive care unit of Chung Shan Medical University Hospital, Taichung, Taiwan, with discharge diagnosis of pleural effusion, chylothorax, hydrothorax, hemothorax, and empyema, from January 1999 to December 2009. The characteristics, etiology, management, and outcome were analyzed. Results There were 21 patients identified, 16 males (76%) and 5 females (24%). Eight patients (38%) had primary and 13 patients (62%) had secondary etiologies. The etiologies included four parapneumonic effusions or empyema (19%); nine chylothorax (42.8%) with four congenital and five iatrogenic after thoracic surgery; three percutaneously inserted central venous catheter extravasation (14%); one umbilical venous catheter extravasation (4.7%); three hydrops fetalis (14%); and one congestive heart failure (4.7%). Fifteen patients (71%) needed chest tube placement. Conservative management with complete cessation of enteral feedings and use of total parenteral nutrition followed with infant formula containing medium-chain triglyceride was successful in six of the patients (67%) with chylothorax. There were two patients (22%) with chylothorax who received somatostatin administration; one was successful and the other one failed. Thoracic duct ligation was performed uneventfully in two patients with acquired chylothorax. There were three mortalities (14.3%) in this study, which were related to causes other than pleural effusion. Conclusions Pleural effusions in the neonatal stage may result from chylothorax, hydrops fetalis, extravasation of percutaneously inserted central venous catheter, parapneumonic effusion, congestive heart failure, or other less frequently occurring conditions. Diagnostic chest tap is required for subsequent management. Good outcome is the rule except in hydrops fetalis, which carries high mortality rate.
URI:	https://ir.csmu.edu.tw:8080/ir/handle/310902500/10880 http://dx.doi.org/10.1016/j.pedneo.2011.06.002
Relation:	Pediatrics & Neonatology Volume 52, Issue 5, October 2011, Pages 251–255
Appears in Collections:	[醫學系] 期刊論文

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