Chylopericardium or contamination by injectable lipid emulsion? (notice n° 136073)

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Language code of text/sound track or separate title fre
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100 10 - MAIN ENTRY--PERSONAL NAME
Personal name Lefrère, Bertrand
Relator term author
245 00 - TITLE STATEMENT
Title Chylopericardium or contamination by injectable lipid emulsion?
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Date of publication, distribution, etc. 2022.<br/>
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General note 67
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Summary, etc. Effusions can show some surprises. We document the case of a fourteen-month-old male patient with short bowel syndrome, hospitalized in a cardiology unit, receiving chronic parenteral nutrition via a Broviac® catheter. The patient presented multiple thromboses following iterative catheter replacements. In parallel with superior vena cava plasty, a right intra-atrial Broviac® catheter was inserted in the absence of other peripheral venous accesses. This device has a cutaneous exit site to allow for infusion of a hyperosmolar lipid emulsion. Seven days later, a milky liquid was secreted from a pericardial/mediastinal Redon drain. A gel lipoprotein electrophoresis of the fluid suggested a preliminary diagnosis of chylopericardium. However, biochemical testing of certain analytes pointed to a parenteral nutrition-related pericardial effusion and a possible pseudo-chyloperitoneum caused by the shearing of a migrated Broviac® in the pericardium. The patient, on a fat-free diet, was admitted to the ICU to drain the effusion and reposition the catheter, with success. In the light of new data on the interference of parenteral lipid emulsions with lipoprotein gel electrophoresis, we attempt to determine whether the apparent presence of chylomicrons in the gel is a sign of a lesion of the lymphatic system, or instead the result of contamination by artificial chylomicron in the lipid emulsion, if not a sign of contaminated blood. In our article, we highlight several considerations for when it comes to identifying and confirming cases of pericardial effusion, including a chylopericardium and parenteral nutrition-related one, as well as points concerning the use of lipid emulsions for pediatric patients with short bowel syndrome.
700 10 - ADDED ENTRY--PERSONAL NAME
Personal name Bittar, Randa
Relator term author
700 10 - ADDED ENTRY--PERSONAL NAME
Personal name Levasseur, Antoine
Relator term author
700 10 - ADDED ENTRY--PERSONAL NAME
Personal name Lambe, Cécile
Relator term author
700 10 - ADDED ENTRY--PERSONAL NAME
Personal name Abi-Nader, Elie
Relator term author
700 10 - ADDED ENTRY--PERSONAL NAME
Personal name Pontailler, Margaux
Relator term author
700 10 - ADDED ENTRY--PERSONAL NAME
Personal name Gaudin, Régis
Relator term author
700 10 - ADDED ENTRY--PERSONAL NAME
Personal name Fesel-Fouquier, Valérie
Relator term author
700 10 - ADDED ENTRY--PERSONAL NAME
Personal name Sakka, Mehdi
Relator term author
700 10 - ADDED ENTRY--PERSONAL NAME
Personal name Bonnefont-Rousselot, Dominique
Relator term author
786 0# - DATA SOURCE ENTRY
Note Annales de Biologie Clinique | 80 | 5 | 2022-09-01 | p. 478-486 | 0003-3898
856 41 - ELECTRONIC LOCATION AND ACCESS
Uniform Resource Identifier <a href="https://shs.cairn.info/journal-annales-de-biologie-clinique-2022-5-page-478?lang=en">https://shs.cairn.info/journal-annales-de-biologie-clinique-2022-5-page-478?lang=en</a>

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