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Utility of an alpha-1 adrenergic agonist in the management of chylothorax: a case series and management algorithm
dc.contributor.author | Peralta, Ruben | |
dc.contributor.author | Ramzee, Ahmed F. | |
dc.contributor.author | Bakhsh, Zeenat Khuda | |
dc.contributor.author | El-Menyar, Ayman | |
dc.contributor.author | Ajaj, Ahmed | |
dc.contributor.author | Al-Thani, Hassan | |
dc.date.accessioned | 2024-08-28T01:36:36Z | |
dc.date.available | 2024-08-28T01:36:36Z | |
dc.date.issued | 2024-07-29 | |
dc.identifier.citation | Peralta R, Ramzee AF, Bakhsh ZK, El-Menyar A, Ajaj A, Al-Thani H. Utility of an Alpha-1 Adrenergic Agonist in the Management of Chylothorax: A Case Series and Management Algorithm. Eur J Case Rep Intern Med. 2024 Jul 29;11(8):004705. doi: 10.12890/2024_004705. PMID: 39130057; PMCID: PMC11313120. | en_US |
dc.identifier.uri | https://repositorio.unphu.edu.do/handle/123456789/5845 | |
dc.description.abstract | Chylothorax is the accumulation of lymphatic fluid (chyle) within the pleural space. There are multiple causes, including traumatic and non-traumatic mechanisms. Trauma can cause disruption of the thoracic duct either by direct damage or indirect crushing or avulsion mechanisms. Non-traumatic causes include infections, inflammatory processes, malignancies, and iatrogenic injury (during surgery or central venous access). The traditional management of traumatic chylothorax has been either a conservative approach, including complete Nil Per Os (NPO), or a low-fat diet with medium-chain triglyceride supplementation with the administration of somatostatin or its analog, octreotide, versus a surgical approach consisting of thoracic duct ligation. Recently a less invasive approach via thoracic duct embolization has gained popularity. There have been a few reports of the successful use of an α 1-adrenergic agonist (midodrine) as an adjunct in the conservative approach. We describe the utility of midodrine in three cases of chylothorax and propose a management algorithm. The initial diagnosis of chylothorax is based on clinical suspicion and proper imaging.The clinical success of midodrine use as a first-line medical treatment for chylothorax will support the use of midodrine before considering invasive procedures.We propose a management algorithm for patients with chylothorax that will stimulate researchers to conduct prospective studies to assess its efficacy. | en_US |
dc.language.iso | en | en_US |
dc.publisher | European Journal of Case Reports in Internal Medicine | en_US |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject | Quilotórax | en_US |
dc.subject | Octreótido | en_US |
dc.title | Utility of an alpha-1 adrenergic agonist in the management of chylothorax: a case series and management algorithm | en_US |
dc.type | Article | en_US |