Effect of intrapleural injection of erythromycin on congenital refractory chylothorax in the newborn

Yun Shi,Ying Zhang

doi:10.4314/tjpr.v19i7.26

Abstract

Purpose: To investigate the therapeutic effect of intrapleural injection of erythromycin on congenital refractory chylothorax in the newborn, in order to provide a more efficient approach for its treatment.Methods: A retrospective study was conducted with 13 cases of congenital chylothorax in newborns that received conventional treatment and intrapleural injection of erythromycin.Results: A total of 10 out of 13 child patients (76.9 %) received active treatment. Furthermore, the patients who received the intrapleural injection of erythromycin were administered the injection a total of 1 - 3 times (1.5 ± 0.6) on the average with the dose ranging from 80 – 210 mg (mean, 126.5 ± 32.7 mg). Thereafter, they received continuous drainage for 7 – 12 days (mean time, 10.2 d). Drainage volume ranged from 50 - 150ml (mean, 84.3 ± 35.2 mL). Patients that did not receive the erythromycin treatment received continuous drainage for 5 – 13 d (mean, 8.6 day), with the drainage volume ranging from 67 - 132 mL (mean, 92.3 ± 25.6 mL).Conclusion: Therefore, intrapleural injection of erythromycin has a certain therapeutic effect on congenital refractory chylothorax in the newborn. Keywords: Erythromycin intrapleural injection, Congenital refractory chylothorax, Newborn

Highlights

The congenital chylothorax in newborns is mainly due to the rupture of the thoracic duct or the thoracic lymph vessel, which makes the lymph leak into the thoracic cavity; this is the most common reason for pleural effusion in newborns [1]
Studies have argued that [5,6] the intrapleural injection of anhydrous alcohol, erythromycin and growth inhibition have a good application value in decreasing the drainage volume and time and improving the cure rate
Patients who did not receive the treatment with erythromycin received continuous drainage (n=6)

Summary

INTRODUCTION

The congenital chylothorax in newborns is mainly due to the rupture of the thoracic duct or the thoracic lymph vessel, which makes the lymph leak into the thoracic cavity; this is the most common reason for pleural effusion in newborns [1]. This study observed the treatment effects of congenital refractory chylothorax on the newborn with the intrapleural injection of erythromycin at our center in comparison with those without erythromycin. The conventional treatment was applied, which included chest drainage, respiratory support, parenteral nutrition, fluid and protein infusion. The drainage volume and residual liquid volume were evaluated via ultrasonic testing every day, and the degree of pulmonary dilation and the airliquid level change was observed This was done in combination with chest radiography. After the drainage was reduced, a non-fat diet was provided instead Those patients with no reduction in drainage flow (> 10 – 15 ml/kg/d) and no remission in symptoms or even aggravation were considered to receive the intrapleural injection of erythromycin in time.

RESULTS

DISCUSSION

Limitations of the study

CONCLUSION

Conflict of interest