Clinical Profile, Treatment and Outcomes of Pediatric Patients with Chylothorax: A 10-year Retrospective Study in a Tertiary Government Hospital

Background. Chylothorax is a rare cause of pleural effusion in children, and various management methods have been proposed, though the optimal treatment remains debated.

Objective. This study aimed to describe the clinical profile, treatment, outcomes, and complications of pediatric patients diagnosed with chylothorax admitted at the University of the Philippines – Philippine General Hospital.

Methods. Pediatric patients diagnosed with chylothorax who underwent chest tube insertion and removal and received dietary modification and/or octreotide/somatostatin as management of chylothorax from January 2014 to January 2024 were included in this retrospective study. The Mann-Whitney U test was used to determine the association between dietary modifications and chylothorax resolution time, while a two-way ANOVA with rank transformation determined the association of initial use of octreotide/somatostatin on resolution time and median drainage volume.

Results. Among a total of 22 patients, most patients developed chylothorax as a complication of cardiothoracic surgery. While fasting led to a shorter resolution time for chylothorax, the difference was not statistically significant. Initial use of octreotide/somatostatin was associated with a significantly longer median resolution time compared to those who did not (p = 0.0466). Factors such as hospital-acquired pneumonia, sepsis, hypoalbuminemia, and nonpostoperative causes of chylothorax influenced outcomes, but did not significantly affect in-hospital mortality or length of hospital stay.

Conclusion. There is no significant difference in time-to-resolution of chylothorax across various initial nutritional strategies. While initial use of octreotide/somatostatin may have significantly provided longer resolution time, larger data sets and prospective controlled trials are still recommended to strongly support this finding.