Fortified Skimmed Mother's Milk in the Management of Chylothorax

NCT ID: NCT01673165

Last Updated: 2015-10-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

17 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-06-30

Study Completion Date

2015-09-30

Brief Summary

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The purpose of this study is to determine if the use of fortified skimmed mother's milk is a safe alternative to specialized formula in the treatment of chylothorax following cardiothoracic surgery.

Detailed Description

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A chylothorax is a collection of fluid around the lungs that can occur after cardiac surgery. The fluid contains chyle, a milky fluid consisting of fat droplets. The standard treatment is to feed an infant with a specialized low fat formula for up to 6 weeks until the chest has time to heal. This formula is generally not well tolerated and mother's of our patients have expressed a desire to continue using breast milk. A few case reports have been published, but there have not been any studies to date looking at this. Data will be collected to include information about nutrition, weight gain, teaching needs, surgical, hospital, and discharge information.

Conditions

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Chylous Pleural Effusion Following Cardiothoracic Surgery

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Specialized Formula

25 infants of mothers who do not have breast milk or do not want to use the skimming technique. These infants will receive our standard of care - specialized formula for the treatment of chylothorax

Group Type ACTIVE_COMPARATOR

Specialized Formula

Intervention Type OTHER

Infants will receive our standard of care - specialized formula

Skimmed mother's milk

25 infants of mothers who have breast milk and who also want to learn the skimming technique will be taught the technique. The infants will then receive the skimmed breast milk for the treatment of chylothorax

Group Type EXPERIMENTAL

Skimmed mother's milk

Intervention Type OTHER

Fortified skimmed mother's milk will be given to the skimmed mother's milk group. The fortifier is a standard fortifier we use in our population

Interventions

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Skimmed mother's milk

Fortified skimmed mother's milk will be given to the skimmed mother's milk group. The fortifier is a standard fortifier we use in our population

Intervention Type OTHER

Specialized Formula

Infants will receive our standard of care - specialized formula

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Infant birth to 12 months of age
* Undergo cardiothoracic surgery
* Develop a chylous effusion
* Be a breastfed or formula fed infant

Exclusion Criteria

* Infant over 12 months of age
* Infant in state custody (foster care)
* Infant with milk protein allergy
* Infant born with congenital chylothorax
* Infant who develops chylothorax from other surgeries (non-cardiac
Minimum Eligible Age

1 Day

Maximum Eligible Age

12 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Gerber Foundation

OTHER

Sponsor Role collaborator

Oregon Health and Science University

OTHER

Sponsor Role lead

Responsible Party

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Cindi Farnstrom

Certified Pediatric Nurse Practitioner

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Cindi Farnstrom, MN, CPNP

Role: PRINCIPAL_INVESTIGATOR

Oregon Health and Science University

Locations

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Oregon Health and Science University - Doernbecher Children's Hospital

Portland, Oregon, United States

Site Status

Countries

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United States

References

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Le Coultre C, Oberhansli I, Mossaz A, Bugmann P, Faidutti B, Belli DC. Postoperative chylothorax in children: differences between vascular and traumatic origin. J Pediatr Surg. 1991 May;26(5):519-23. doi: 10.1016/0022-3468(91)90696-q.

Reference Type BACKGROUND
PMID: 2061800 (View on PubMed)

Milonakis M, Chatzis AC, Giannopoulos NM, Contrafouris C, Bobos D, Kirvassilis GV, Sarris GE. Etiology and management of chylothorax following pediatric heart surgery. J Card Surg. 2009 Jul-Aug;24(4):369-73. doi: 10.1111/j.1540-8191.2008.00781.x.

Reference Type BACKGROUND
PMID: 19583606 (View on PubMed)

Chan EH, Russell JL, Williams WG, Van Arsdell GS, Coles JG, McCrindle BW. Postoperative chylothorax after cardiothoracic surgery in children. Ann Thorac Surg. 2005 Nov;80(5):1864-70. doi: 10.1016/j.athoracsur.2005.04.048.

Reference Type BACKGROUND
PMID: 16242470 (View on PubMed)

Beghetti M, La Scala G, Belli D, Bugmann P, Kalangos A, Le Coultre C. Etiology and management of pediatric chylothorax. J Pediatr. 2000 May;136(5):653-8. doi: 10.1067/mpd.2000.104287.

Reference Type BACKGROUND
PMID: 10802499 (View on PubMed)

Bond SJ, Guzzetta PC, Snyder ML, Randolph JG. Management of pediatric postoperative chylothorax. Ann Thorac Surg. 1993 Sep;56(3):469-72; discussion 472-3. doi: 10.1016/0003-4975(93)90881-h.

Reference Type BACKGROUND
PMID: 8379718 (View on PubMed)

Suddaby EC, Schiller S. Management of chylothorax in children. Pediatr Nurs. 2004 Jul-Aug;30(4):290-5.

Reference Type BACKGROUND
PMID: 15511045 (View on PubMed)

Allen EM, van Heeckeren DW, Spector ML, Blumer JL. Management of nutritional and infectious complications of postoperative chylothorax in children. J Pediatr Surg. 1991 Oct;26(10):1169-74. doi: 10.1016/0022-3468(91)90325-n.

Reference Type BACKGROUND
PMID: 1779326 (View on PubMed)

Lessen R. Use of skim breast milk for an infant with chylothorax. ICAN: Infant, Child, & Adolescent Nutrition. 2009; 1(6):303-310.

Reference Type BACKGROUND

Chan GM, Lechtenberg E. The use of fat-free human milk in infants with chylous pleural effusion. J Perinatol. 2007 Jul;27(7):434-6. doi: 10.1038/sj.jp.7211768. Epub 2007 Jun 7.

Reference Type BACKGROUND
PMID: 17554391 (View on PubMed)

Staats BA, Ellefson RD, Budahn LL, Dines DE, Prakash UB, Offord K. The lipoprotein profile of chylous and nonchylous pleural effusions. Mayo Clin Proc. 1980 Nov;55(11):700-4.

Reference Type BACKGROUND
PMID: 7442324 (View on PubMed)

Cormack BE, Wilson NJ, Finucane K, West TM. Use of Monogen for pediatric postoperative chylothorax. Ann Thorac Surg. 2004 Jan;77(1):301-5. doi: 10.1016/s0003-4975(03)01189-5.

Reference Type BACKGROUND
PMID: 14726083 (View on PubMed)

Orange JS, Geha RS, Bonilla FA. Acute chylothorax in children: selective retention of memory T cells and natural killer cells. J Pediatr. 2003 Aug;143(2):243-9. doi: 10.1067/S0022-3476(03)00305-6.

Reference Type BACKGROUND
PMID: 12970641 (View on PubMed)

Sheeran T, Marvin RS, Pianta RC. Mothers' resolution of their child's diagnosis and self-reported measures of parenting stress, marital relations, and social support. J Pediatr Psychol. 1997 Apr;22(2):197-212. doi: 10.1093/jpepsy/22.2.197.

Reference Type BACKGROUND
PMID: 9114643 (View on PubMed)

Wang CD, Chu PS, Mellen BG, Shenai JP. Creamatocrit and the nutrient composition of human milk. J Perinatol. 1999 Jul-Aug;19(5):343-6. doi: 10.1038/sj.jp.7200204.

Reference Type BACKGROUND
PMID: 10685254 (View on PubMed)

Chatterjee R, Chatterjee S, Datta T, Roy B, Marimuthu P. Longitudinal study of human milk creamatocrit and weight gain in exclusively breastfed infants. Indian Pediatr. 1997 Oct;34(10):901-4.

Reference Type BACKGROUND
PMID: 9567552 (View on PubMed)

Lucas A, Gibbs JA, Lyster RL, Baum JD. Creamatocrit: simple clinical technique for estimating fat concentration and energy value of human milk. Br Med J. 1978 Apr 22;1(6119):1018-20. doi: 10.1136/bmj.1.6119.1018.

Reference Type BACKGROUND
PMID: 638579 (View on PubMed)

Buttiker V, Fanconi S, Burger R. Chylothorax in children: guidelines for diagnosis and management. Chest. 1999 Sep;116(3):682-7. doi: 10.1378/chest.116.3.682.

Reference Type BACKGROUND
PMID: 10492271 (View on PubMed)

Lewis CC, Scott DE, Pantell RH, Wolf MH. Parent satisfaction with children's medical care. Development, field test, and validation of a questionnaire. Med Care. 1986 Mar;24(3):209-15. doi: 10.1097/00005650-198603000-00003.

Reference Type BACKGROUND
PMID: 3951263 (View on PubMed)

Berseth CL, Mitmesser SH, Ziegler EE, Marunycz JD, Vanderhoof J. Tolerance of a standard intact protein formula versus a partially hydrolyzed formula in healthy, term infants. Nutr J. 2009 Jun 19;8:27. doi: 10.1186/1475-2891-8-27.

Reference Type BACKGROUND
PMID: 19545360 (View on PubMed)

Other Identifiers

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Gerber7747

Identifier Type: -

Identifier Source: org_study_id

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