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Subject:
From:
Arnetta Dailey <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 3 Dec 1996 10:36:22 -0500
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In a message dated 96-12-03 00:05:32 EST, you write:

<< Chylothorax >>

What causes the problem Chylothorax, or chylous effusion, is the result of
damage or obstruction to the thoracic lymph duct that causes it to leak chyle
into the pleural space. Possible causes include traumatic chest injury,
tumor, and surgery involving the heart, aorta, esophagus, or left subclavian
vessels. Rapid accumulation of chyle compresses the lungs, reducing lung
ventilation and perfusion and shifting
the mediastinum. This distorts the great vessels and causes hemodynamic
compromise.
     Chyle contains fat, protein, and lymphocytes. The removal of chyle from
the lymphatic system in chylothorax reduces the number of circulating
lymphocytes, predisposing the patient to infection. The loss of proteins,
fats, and fat-soluble vitamins may also cause serious metabolic deficits.
     If the effusion develops suddenly with rapid loss of intravascular
volume, the patient will have severe respiratory distress, tachycardia,
hypotension, pallor, cyanosis, thready pulse, clammy skin, below-normal
temperature, and shock. If it develops more slowly, signs and symptoms may be
less specific--malaise, fatigue, dyspnea on exertion, and a sensation of
heaviness on the affected side of the chest.


Arnetta Dailey RN IBCLC
The Woodlands Texas

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