Body weight was maintained or increased in 14 of the 17 surviving patients taking Monogen. 2017 Sep-Oct;32(5):390-393. doi: 10.21470/1678-9741-2017-0011.North Clin Istanb. Shaw V, Lawson M. The cardiothoracic system. The purpose of this study was to report the use of Monogen enteral formula for the management of pediatric postoperative chylothorax.A retrospective, single-institution 2-year study of all patients with a diagnosis of postoperative chylothorax was conducted.
$68.61. He died of multiorgan failure, although the chylothorax had resolved.Six patients had TPN as their initial treatment because they were unstable neonates or infants with high pleural drain volumes in the ICU rather than in the cardiac ward. Address reprint requests to Ms Cormack, Nutrition Services, Green Lane Hospital, Greenlane West, Auckland 1030, New Zealand.Nutrition Services, Green Lane Hospital, Auckland, New ZealandPediatric Cardiology Department, Green Lane Hospital, Auckland, New ZealandCardiothoracic Surgical Unit, Green Lane Hospital, Auckland, New ZealandBiostatistics Department, Green Lane Hospital, Auckland, New Zealand This result confirms 6 weeks on the low LCT diet from the day of the last pleural drain removal is long enough to avoid recurrence. eCollection 2015.Akbari Asbagh P, Navabi Shirazi MA, Soleimani A, Razzaz M, Akbari Asbagh N, Rayatzadeh H, Shariat M. Chylothoraces had resolved by 3.5 days in 78% of patients. Shake or stir Monogen immediately before use. A comparative study of parenteral versus enteral nutrition.The management of chylothorax chylopericardium following pediatric cardiac surgery.Conservative versus surgical management of chylothorax.Management of chylothorax in children by thoracentesis and medium-chain triglyceride feedings.Management of nutritional and infectious complications of post-operative chylothorax in children.A review of the nutritional management of chyle leakage in adults.© 2003 The Society of Thoracic Surgeons. Nineteen cases had enteral nutrition as their initial form of treatment. Infants ≤12 months . Kindergen.
In our study, the mean interval from surgery to diagnosis was 5.9 days in the Monogen group (range 1 to 21 days). None of the patients reaccumulated chyle after they were switched to a normal diet within 6 weeks, nor did the 6 patients who received Monogen for less than 4 weeks. Please enter your username and password; Login. doi: 10.1016/s0003-4975(03)01189-5. Add a small amount of the water prescribed. Children >10 years. • Each level scoop (5.6g) of Monogen requires 30ml to yield the recommended feed concentration of 16.8% • For preparation of infant formula, please refer to the factsheet • For preparation for older children, please follow guidelines below.
Postoperative chylothorax is a potentially serious complication of pediatric cardiac surgery. Chylothorax was diagnosed in 25 patients after a total of 535 cardiac operations in children younger than 10 years, for an incidence of 4.7%. These 4 patients were changed to TPN.
example, Monogen (available from Nutricia of North America) is a milk protein-based powdered formula that is low in fat (25% of calories) of which 90% is in the form of MCT.12 Other enteral products that are low in LCFAs are avail-able and may be considered (see Table 3 for a description of products). In: Shaw V, Lawson M, eds. Patients were identified by the hospital diagnostic coding index and dietitians' records.
However, TPN has disadvantages, including gut stasis, catheter-related sepsis, and cost.Our success with Monogen has led us to adjust our initial policy and we now intend to use the formula in ICU patients unless enteral feeding is completely contraindicated. doi: 10.1016/s0003-4975(03)01189-5. Medium Chain Triglyceride Formula. A retrospective study of all pediatric patients at Green Lane Hospital treated for postoperative chylothorax for the next 2 years was conducted. Compared with Portagen, Monogen has a lower level of long-chain triglycerides (LCT; 1.4 g/L) and a higher energy level of 74 kcal/100 mL; thus Monogen was thought to be a better choice (From June 1999 Monogen was used as the enteral feed for postoperative chylothorax in our institution. Baseline characteristics were compared using a Mann-Whitney Twenty-five cases were identified, of whom 23 patients survived. The characteristics of patients who responded to either Monogen or TPN, defined as nutritional treatment, were also compared with those who did not respond to nutritional treatment. Love & Care Gentle Infant Formula Milk-Based Powder with Iron, 12 Ounce (Pack of 6) 4.5 out of 5 stars 31. This interval is shorter than Le Coultre's reported mean of 9.8 days and Beghetti's mean of 7.3 days for those who recovered quickly and 14 days for those with longstanding chylous losses [Postoperative chylothorax in children difference between vascular and traumatic origin.With 92% survival, our group compares well with other published survival rates as summarized in Monogen is an effective high-energy enteral nutrition treatment for postoperative chylothorax in children.
Eighteen patients had been given Monogen, an enteral low long-chain triglyceride formula, as initial treatment. Of these, 18 had Monogen; 1 older child who presented 24 days postoperatively had 4 days on Monogen and a minimal LCT fat diet.
Patients with the largest drain volumes tended not to have their triglyceride levels measured, as the diagnosis was intuitive.Baseline characteristics were compared between the group who responded to Monogen and Monogen nonresponders. Values presented as median (interquartile range) unless otherwise noted.Overall duration of the chylothorax from day of diagnosis for the Monogen group varied from 2 to 36 days, with a median of 4.5 days of drainage. Weight loss was minimal in the other 18% (n = 3), less than 3% of total body weight. EleCare Vanilla.
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