Abstract
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 4 specialties (Pulmonary, Interventional Radiology, Thoracic Surgery & Nutrition) with experience and expertise in managing adult patients with chylothorax. We performed a literature and internet search for reports addressing 7 clinically relevant questions pertaining to the management of adult patients with chylothorax. This consensus statement, consisting of best practice statements based on expert consensus addressing these 7 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 inform future research.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Author contributors: AA and UC serve as principal authors having full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. AA, UC, SS, GN, ML and FM contributed to conception and design of the work, data acquisition, data analysis, data interpretation, and drafting of the manuscript. YGL, NMR, JR, MF, MD, EG, EB, BC, DFK, AD, KF, VB, YG, HG, JC, RL, PK, AK, RM, KD, HD contributed substantially to the study design, data analysis and interpretation, and the writing of the manuscript. All authors contributed to critical revision of the manuscript for intellectual content and all are responsible for the content of this paper.
Conflict of interests: DFK is an educational consultant for AstraZeneca, Noah Medical, Boston Scientific outside the submitted work. JC 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. YGL receives drainage kits without charge for participants of a clinical trial he leads. HG has a sponsored research agreement with Known Medicine. MD is an educational consultant for PulmonX (DSMB) and is on the scientific advisory board for Pleural Dynamics. JR has a research grant with Intuitive Surgical and is an educational consultant for Vergent, Isola, Medview and Imvaria outside the submitted work. FM received research funding from Medtronic and personal consulting fees from J&J and Intuitive, outside of the submitted work. The other authors do not have any disclosures or conflicts of interest to report.
- Received March 8, 2024.
- Accepted September 4, 2024.
- Copyright ©The authors 2024. For reproduction rights and permissions contact permissions{at}ersnet.org
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