Multidisciplinary management of adult patients with chylothorax: a consensus statement.

Autor:	Agrawal A; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA abhinav72@gmail.com.; Contributed equally as joint first authors., Chaddha U; Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Contributed equally as joint first authors., Shojaee S; Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA., Nadolski G; University of Pennsylvania, Philadelphia, PA, USA., Liberman M; University of Montreal, Montreal, QC, Canada., Lee YCG; University of Western Australia, Perth, Australia., Rahman N; Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK., Reisenauer JS; Mayo Clinic, Rochester, MN, USA., Ferguson MK; University of Chicago, Chicago, IL, USA., DeCamp MM; Division of Cardiothoracic Surgery, University of Wisconsin, Madison, WI, USA., Gillaspie EA; Creighton University Medical Center, Omaha, NE, USA., Bedawi EO; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK., Currie B; New York-Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USA., Feller-Kopman DJ; Pulmonary and Critical Care Medicine, Darmouth-Hitchcock Medical Center, The Geisel School of Medicine at Dartmouth, Hanover, NH, USA., Desai A; University of Mississippi Medical Center, Jackson, MS, USA., Yasufuku K; Division of Thoracic Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada., Bishay V; Icahn School of Medicine at Mount Sinai, New York, NY, USA., Gesthalter Y; Division of Pulmonary, Critical Care, Allergy and Sleep, University of California San Francisco, San Francisco, CA, USA., Grosu H; University of Texas, MD Anderson Cancer Center, Houston, TX, USA., Chick JFB; University of Washington, Seattle, WA, USA., Lentz R; Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA., Kolli KP; Division of Body Interventional Radiology, University of California San Francisco, San Francisco, CA, USA., Kaufman A; Icahn School of Medicine at Mount Sinai, New York, NY, USA., Mehta RM; Apollo Bangalore Pulmonary Services, Apollo Hospitals Bangalore, Bangalore, India., Desai K; Northwestern University Feinberg School of Medicine, Chicago, IL, USA., Davis H; University of Texas, MD Anderson Cancer Center, Houston, TX, USA., Ghori UK; Medical College of Wisconsin, Milwaukee, WI, USA., Maldonado F; Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Jazyk:	angličtina
Zdroj:	The European respiratory journal [Eur Respir J] 2024 Nov 07; Vol. 64 (5). Date of Electronic Publication: 2024 Nov 07 (Print Publication: 2024).
DOI:	10.1183/13993003.00470-2024
Abstrakt:	The management of chylothorax remains challenging given the limited evidence and significant heterogeneity in practice. In addition, there are no practical guidelines on the optimal approach to manage this complex condition. We convened an international group of 27 experts from 20 institutions across five countries and four specialties (pulmonary, interventional radiology, thoracic surgery and nutrition) with experience and expertise in managing adult patients with chylothorax. We performed a literature and internet search for reports addressing seven clinically relevant PICO (Patient, Intervention, Comparison and Outcome) questions pertaining to the management of adult patients with chylothorax. This consensus statement, consisting of best practice statements based on expert consensus addressing these seven PICO questions, was formulated by a systematic and rigorous process involving the evaluation of published evidence, augmented with provider experience. Panel members participated in the development of the final best practice statements using the modified Delphi technique. Our consensus statement aims to offer guidance in clinical decision making when managing patients with chylothorax while also identifying gaps in knowledge and informing future research. Competing Interests: Conflict of interest: Y.C.G. Lee receives drainage kits without charge for participants of a clinical trial he leads. J.S. Reisenauer has a research grant with Intuitive Surgical and is an educational consultant for Vergent, Isola, Medview and Imvaria, outside the submitted work. M.M. DeCamp is an educational consultant for PulmonX and is on the scientific advisory board for Pleural Dynamics. D.J. Feller-Kopman is an educational consultant for AstraZeneca, Noah Medical and Boston Scientific, outside the submitted work. H. Grosu has a sponsored research agreement with Known Medicine. J.F.B. Chick is an educational consultant and speaker for Inari Medical, Guerbet, C. R. Bard, Argon Medical Devices, Boston Scientific, NXT Biomedical and AiDoc, outside the submitted work. F. Maldonado received research funding from Medtronic and personal consulting fees from J&J and Intuitive, outside of the submitted work. The remaining authors do not have any disclosures or conflicts of interest to report. (Copyright ©The authors 2024. For reproduction rights and permissions contact permissions@ersnet.org.)
Databáze:	MEDLINE
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