Journal/Magazine Articles

Permanent URI for this collectionhttp://repository.kln.ac.lk/handle/123456789/13

This collection contains original research articles, review articles and case reports published in local and international peer reviewed journals by the staff members of the Faculty of Medicine

Browse

Filters

20211

Settings

Author: search.filters.author.Senarathne, U.D.Subject: search.filters.subject.neonatal intensive care

Search Results

Now showing 1 - 1 of 1
  • Thumbnail Image
    Item
    Milky pleural effusion in a neonate and approach to investigating chylothorax
    (BMJ Publishing Group, 2021) Senarathne, U.D.; Rodrigo, R.; Dayanath, B.K.T.P.
    Neonatal chylothorax is a rare presentation leading to significant respiratory distress, thus requiring timely diagnosis. A preterm neonate was resuscitated and ventilated, following which she clinically improved but subsequently developed respiratory distress with a right-sided pleural effusion. Interestingly, thoracentesis fluid appeared 'milky' with elevated triglycerides and lymphocytes, suggesting chylothorax. As fluid triglyceride level was lower than the established diagnostic criterion for chylothorax (1.24 mmol/L), a high fluid-to-serum triglyceride ratio was used as a surrogate diagnostic marker, later confirmed by lipoprotein electrophoresis. As observed in the index patient, a critically ill neonate would have a lower-than-average fat intake leading to less chylomicron production, thus lower triglyceride levels in chyle than expected, which may still fail to meet the amended cut-off limit. This case highlights the challenges in diagnosing neonatal chylothorax due to the lack of age-specific triglyceride levels in chyle and low oral fat intake in critically ill patients.