Neonatal chylothorax and ultrasound: Diagnosis, measurements, and correlations with management
Abstract
BACKGROUND: Chylothorax is a rare condition in neonates. It is associated with increased mortality, prolonged hospital stay, and significant nutritional, metabolic, and immunological complications. We hypothesized that lung ultrasound may play a critical role in managing this condition. However, standardized ultrasound parameters for the management of chylothorax have not currently been identified.
AIM: To determine preliminary ultrasound measurement parameters for chylothorax in neonates and to assess their usefulness for future prospective studies.
METHODS: We retrospectively reviewed 10 cases of congenital chylothorax in neonates admitted to the neonatal intensive care unit at Fondazione Policlinico Universitario A. Gemelli. We collected the following standardized ultrasound measurements: Lung-chest wall distance, lung-diaphragm distance, and derived area. Finally, the correlation between these measurements was analyzed according to the primary outcome of the need for drainage.
RESULTS: The median gestational age of the study infants was 34.7 weeks. Five neonates required thoracentesis, and seven needed pleural drainage placement. Ultrasound evaluations were performed at birth and subsequently every 48 hours, or more frequently in cases of clinical instability. The receiver operating characteristic curves gave these values for the proposed measurements (setting the chest tube drainage as the outcome): Lung-chest wall distance [area under the curve (AUC) = 0.917; 95% confidence interval (CI): 0.810-1]; lung-diaphragm distance (AUC = 0.938; 95%CI: 0.869-1); derived area (AUC = 0.984; 95%CI: 0.954-1); cut-off values of 0.8 cm, 1.2 cm and 0.72 cm2 were identified for the lung-chest wall distance, lung-diaphragm distance, and derived area, respectively.
CONCLUSION: Lung ultrasound may be a valuable tool in the management of neonates with chylothorax. Future studies with a larger cohort are needed to confirm our findings.
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BibTeX
@article{perri2026neonatal,
title = {{Neonatal chylothorax and ultrasound: Diagnosis, measurements, and correlations with management}},
author = {Alessandro Perri and Annamaria Sbordone and Simona Fattore and Alessia De Matteis and Giulia Rotunno and Giovanni A Marrocco and Stefano Nobile and Lucia Giordano and Milena Tana and Giovanni Vento},
journal = {World Journal of Clinical Pediatrics},
year = {2026},
month = nov,
doi = {10.5409/wjcp.117885},
url = {https://doi.org/10.5409/wjcp.117885},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Neonatal chylothorax and ultrasound: Diagnosis, measurements, and correlations with management
AU - Alessandro Perri
AU - Annamaria Sbordone
AU - Simona Fattore
AU - Alessia De Matteis
AU - Giulia Rotunno
AU - Giovanni A Marrocco
AU - Stefano Nobile
AU - Lucia Giordano
AU - Milena Tana
AU - Giovanni Vento
PY - 2026
DA - 2026/11/03
JO - World Journal of Clinical Pediatrics
DO - 10.5409/wjcp.117885
UR - https://doi.org/10.5409/wjcp.117885
AB - BACKGROUND: Chylothorax is a rare condition in neonates. It is associated with increased mortality, prolonged hospital stay, and significant nutritional, metabolic, and immunological complications. We hypothesized that lung ultrasound may play a critical role in managing this condition. However, standardized ultrasound parameters for the management of chylothorax have not currently been identified. AIM: To determine preliminary ultrasound measurement parameters for chylothorax in neonates and to assess their usefulness for future prospective studies. METHODS: We retrospectively reviewed 10 cases of congenital chylothorax in neonates admitted to the neonatal intensive care unit at Fondazione Policlinico Universitario A. Gemelli. We collected the following standardized ultrasound measurements: Lung-chest wall distance, lung-diaphragm distance, and derived area. Finally, the correlation between these measurements was analyzed according to the primary outcome of the need for drainage. RESULTS: The median gestational age of the study infants was 34.7 weeks. Five neonates required thoracentesis, and seven needed pleural drainage placement. Ultrasound evaluations were performed at birth and subsequently every 48 hours, or more frequently in cases of clinical instability. The receiver operating characteristic curves gave these values for the proposed measurements (setting the chest tube drainage as the outcome): Lung-chest wall distance [area under the curve (AUC) = 0.917; 95% confidence interval (CI): 0.810-1]; lung-diaphragm distance (AUC = 0.938; 95%CI: 0.869-1); derived area (AUC = 0.984; 95%CI: 0.954-1); cut-off values of 0.8 cm, 1.2 cm and 0.72 cm2 were identified for the lung-chest wall distance, lung-diaphragm distance, and derived area, respectively. CONCLUSION: Lung ultrasound may be a valuable tool in the management of neonates with chylothorax. Future studies with a larger cohort are needed to confirm our findings.
SN - 2219-2808
ER -