Medical Term of the Day: Chylothorax

Early last night, Ayden's chest tube was put in.  The procedure went off without a hitch.  We had barely arrived back up to his room on the floor to wait when they called to say they were done (he went down to the PCCU to get the tube).  The tube immediately put out about 40cc of fluid (now up to about 150cc).

The fluid that has come out is milky in color.  The lab test confirmed what the visual information seemed to indicate: the fluid is chylothorax.  Chylothorax comes from the lymphatic system.  Among other things, the lymphatic system transports fatty acids from the intestines to the blood stream (most fatty acids are too large to be absorbed by the intestines and therefore cannot get into the blood that way).  Should the fatty acids leak out of the system, chylothorax can result.  We suspect this is what's going on with Ayden (one of the junction points of the lymphatic system can be damaged during the types of surgery he's had).

So, what do we do?  Well, step #1 is to switch him to a different formula, one which contains smaller fatty acid molecules that can be absorbed by the intestines.  Hopefully, this will cease transportation of fatty acids by the lymphatic system, which will in turn allow the leak (if there is one) to heal.  If that does the trick, the chest tube output should cease.  If not, we'll go on to step #2, which has something to do with lung pressures.  I won't attempt to explain it because I don't understand it myself.

In the meantime, Ayden is being such a trooper about this.  He went NPO at 3:30 yesterday morning for a procedure that happened almost 12 hours later than expected.  Thus, he basically got no food yesterday.  Yet, the entire day, he was happy and playful.  He got grumpy at times overnight after the tube was in, but that's to be expected (chest tubes are apparently one of the most painful things these kids can experience).

One other item of note:  he's been off oxygen altogether since early this morning.  Hopefully, we've discovered the final problem that was inhibiting his lung function, he'll stay off the oxygen, keep the fluid out of his lungs, and go home for good (well, for about two years) soon.