Abstract:

Objective To investigate the outcome of intrapleural instillation of erythromycin for treatment of neonates with congenital chylothorax. Methods The clinical data of neonates with diagnosis of congenital chylothorax between January 2007 and December 2011 were retrospectively analysed, and those caused by operations were excluded. Conservative treatment has been carried out for all neonates, including drainage of pleural fluid, respiratory support, total parenteral nutrition and supplementation of lost electrolytes and protein. Intrapleural instillation of erythromycin was done in those with no response to treatment, whose amount of pleural effusion was ＞ 10-15 mL/(kg·d) for two weeks. Follow up with telephone survey was conducted in June 2012, and pulmonary function tests were performed in part of the neonates. Results Sixteen neonates were diagnosed as congenital chylothorax, and intrapleural instillation of erythromycin was conducted in 7 (once in 2 neonates, twice in 3, 3 times in 1, and 4 times in 1). The pleural fluid significantly decreased till disappeared, and none of these cases required surgical intervention, with the effective rate of 100%. The duration required for chest drainage after intrapleural instillation of erythromycin was significantly shorter than that before intrapleural instillation of erythromycin （P<0.01）.The follow-up findings indicated that there was no significant difference in the parameters of pulmonary function tests between neonates with intrapleural instillation of erythromycin and those without （P>0.05）. Conclusion Intrapleural instillation of erythromycin is a safe and effective treatment for neonates with congenital chylothorax, which is a conservative method worthy of clinical application.

Key words: neonate, chylothorax, erythromycin, treatment