Multidisciplinary management of adult patients with chylothorax: a consensus statement
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.
Authors
- Erin A. Gillaspie (ORCID: https://orcid.org/0000-0003-2075-5534)
- Malcolm M. DeCamp
- Ajinkya Desai (ORCID: https://orcid.org/0000-0001-5642-4193)
- Mark K. Ferguson (ORCID: https://orcid.org/0000-0001-6651-7668)
- Yaron Gesthalter (ORCID: https://orcid.org/0000-0002-2762-6404)
- Uzair Ghori (ORCID: https://orcid.org/0000-0002-2633-977X)
- Ravindra M. Mehta (ORCID: https://orcid.org/0000-0003-2015-0236)
- Moïshe Liberman (ORCID: https://orcid.org/0000-0002-9964-1232)
- Janani Reisenauer (ORCID: https://orcid.org/0000-0002-8824-6691)
- Abhinav Agrawal (ORCID: https://orcid.org/0000-0003-1080-6449)
- Fabien Maldonado (ORCID: https://orcid.org/0000-0002-6504-2063)
- V. Bishay
- Udit Chaddha (ORCID: https://orcid.org/0000-0003-0067-1616)
- Andrew Kaufman
- Heather Davis (ORCID: https://orcid.org/0000-0003-1475-4076)
- Najib Mahboob Rahman (ORCID: https://orcid.org/0000-0003-1195-1680)
- Samira Shojaee (ORCID: https://orcid.org/0000-0001-9228-209X)
- Eihab O. Bedawi (ORCID: https://orcid.org/0000-0001-9196-3934)
- Kush Desai (ORCID: https://orcid.org/0000-0003-4976-8531)
- G. Nadolski (ORCID: https://orcid.org/0000-0003-4721-8288)
- Jeffrey Forris Beecham Chick (ORCID: https://orcid.org/0000-0001-9626-6142)
- David Feller‐Kopman (ORCID: https://orcid.org/0000-0002-9008-3617)
- Horiana B. Grosu (ORCID: https://orcid.org/0000-0003-2384-4268)
- K. Kolli (ORCID: https://orcid.org/0000-0001-7820-6082)
- Robert J. Lentz (ORCID: https://orcid.org/0000-0002-8186-0832)
- Gary Lee (ORCID: https://orcid.org/0000-0002-0036-511X)
- Kazuhiro Yasufuku
- Brian Currie
Institutions
- Dartmouth College (US)
- Northwestern University (US)
- Dartmouth–Hitchcock Medical Center (US)
- Northwell Health (US)
- University Health Network (CA)
- Apollo Hospitals (IN)
- NewYork–Presbyterian Hospital (US)
- The University of Texas MD Anderson Cancer Center (US)
- University of Wisconsin–Madison (US)
- The University of Western Australia (AU)
- University of California, San Francisco (US)
- University of Toronto (CA)
- University of Washington (US)
- Medical College of Wisconsin (US)
- Cornell University (US)
- CHI Health Creighton University Medical Center - Bergan Mercy (US)
- New York Hospital Queens (US)
- Toronto General Hospital (CA)
- Jackson Memorial Hospital (US)
- University of California System (US)
- University of Mississippi Medical Center (US)
- University of Illinois Chicago (US)
- University of Oxford (GB)
- University of Chicago (US)
- Presbyterian Hospital (US)
- China First Heavy Industries (China) (CN)
- Sheffield Teaching Hospitals NHS Foundation Trust (GB)
- Donald & Barbara Zucker School of Medicine at Hofstra/Northwell (US)
- Mayo Clinic in Arizona (US)
- Apollo Hospitals (IN)
- Mayo Clinic in Florida (US)
- Université de Montréal (CA)
- University of San Francisco (US)
- University of Pennsylvania (US)
- Vanderbilt University Medical Center (US)
- Philadelphia University (US)
- Icahn School of Medicine at Mount Sinai (US)
Publication Details
- Journal
- European Respiratory Journal
- Published
- 2024-09-26
- DOI
- https://doi.org/10.1183/13993003.00470-2024
- Citations
- 4
- Primary Topic
- Lymphatic Disorders and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 2.29