Medium-chain triglycerides and total parenteral nutrition in the management of infants with congenital chylothorax

Enriched MCT (medium-chain triglycerides) formula has been used in the management of infants with congenital chylothorax (CC). Administration of total parenteral nutrition (TPN) has also been suggested. I evaluated the effect of these two regimens on the course of infants with CC described in the literature, in addition to two new cases reported herein. There were 29 infants who received non-MCT formulas. Twelve infants were given MCT formulas and/or parenteral nutrition. The total volume and duration of pleural effusion were decreased with these regimens, and there were no associated deaths. Data suggest that infants with CC must initially be given an enriched MCT formula. If pleural effusion persists, then total parenteral nutrition should be considered.