Term
| How does chylothorax typicall present? |
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Definition
| It typically presents similar to pleural effusion, with milky white fluid removed during thoracentesis |
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Term
| How does chylous ascites present? |
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Definition
| Chylous ascites presents as symptomatic ascites |
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Term
| What is the most common cause of chylous issues? |
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Definition
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Term
| What are the most common electrolyte disturbances associated with chyle leak? |
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Definition
| Hyponatremia and hypocalcemia |
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Term
| How does chyle leak affect serum protein levels? |
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Definition
| It can result in reduced serum protein levels |
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Term
| What are the inclusion criteria for conservative treatment of chyle leak? How long should conservative treatment be attempted for? |
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Definition
| Conservative treatment is appropriate for healthy, stable patients. It should be provided for no more than 2 weeks. |
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Term
| What factors indicate the need to progress from conservative measures to surgical intervention in the case of chyle leak? |
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Definition
- Excessive chyle output (>500 mL/d in adults or in children by >10 mL/kg/d or >100 mL/d for each year of age) for >5 days
- Persistent leak of any volume for >2 weeks
- Nutritional, metabolic, or infection complications
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Term
| Should patients with chyle leak be initiated on PN or oral diet? |
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Definition
| Most investigators recommend assessing patient's response to an elemental low-fat diet before advancing to PN |
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Term
| What type of diet should be used for chyle leak? |
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Definition
| High protein, little or no LCFAs (<10 g/day) |
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Term
| What type of EN formula should be used in chyle leak patients? |
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Definition
| Elemental low-fat. MCTs can be added as substitute for dietary fat. |
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Term
| Can PN chyle leak patients be placed on clear liquids? |
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Definition
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Term
| What additive can be added to PN to improve chyle leak? |
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Definition
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Term
| Are albumin infusions advisable for chyle leak patients? |
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Definition
| No. However, proteins, coagulation factors, and immunoglobulins may be replaced. |
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Term
| How should diet be advanced after chyle leak cessates? |
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Definition
| After cessation of chyle leak, food intake can be reintroduced and restrictions removed (patients typicall advance to low-fat diet) |
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