Abstract

Author(s): Cirilo, Marry Aneyts de Santana1; Xavier do Nascimento, Claudete2; Soares de Sousa, Bruno2

Introduction:Chylothorax is a pathological condition, where in many cases it compromises the nutritional status due to the continuous loss of the kilo with consequent immunological damage. The objective of this study was to describe the clinical and nutritional results observed after early nutritional intervention through enteral therapy with a homemade formula based on casein, maltodextrin, medium chain triglyceride (MCT) and trace elements.

Method: This is a descriptive observational case report of a patient diagnosed with chylothorax secondary to follicular non-Hodgkin lymphoma.

Results: The institution of early nutritional therapy concomitant with conservative treatment seemed to infer a slight decrease in chylousdebit, however, there was only a significant improvement of the clinical condition, after the diagnosis of lymphoma and the beginning of treatment of the base disease, in this case, chemotherapy. Regarding the nutritional aspect, there was a discreet nutritional loss from admission to discharge, so early therapy, although not effective in reversing nutritional status, preserved it and maintained its functional capacity

Discussion: Etiologic diagnosis and early treatment are essential in the favorable clinical outcome. There are two nutritional therapeutic options, although there is no consensus among which is more effective in reversing the pathological condition, although it is already well established that the supply of medium chain triglyceride (MCT) via enteral or parenteral together with gastrointestinal rest are effective adjuvants in decreased chylous flow rate.

Conclusion: The early enteral support with nasoenteral TCM supply behaved as a coadjuvant in the treatment of chylothorax, although not restoring nutritional status is able to maintain it. Conservative therapy only showed significant results from the beginning of treatment of the underlying disease, in this case cancer, reinforcing the importance of a rapid clinical diagnosis