Photo Source: https://quizlet.com/73910648/27-flash-cards/ Nutrition Management and Intervention of a Chyle Leak
During my clinical rotation I was introduced to a new intestinal challenge, a chyle leak. Not many dietetic interns or even Registered Dietitians see this in day-to-day practice due to its very low incidence rate. Throughout my clinical rotation I encountered three patients diagnosed with a chyle Leak and was able to expand my knowledge on the importance of nutrition management and intervention during the time of a chyle leakage. Chyle is a milky-like-fluid consisting of lymph and chylomicrons made in the small intestine during the digestion of dietary content and drained by lacteals into the lymphatic system. One liter contains roughly 200 calories, 20-30g protein, and 5-30 g fat. A chyle leak is a very rare complication most commonly caused by a postoperative complication, nick, or obstruction following abdominal, neck or thoracic surgeries. Nutrition related complications and concerns are: malnutrition- loss of calories, protein, and fat soluble vitamins, and hypovolemia -loss of fluid and electrolytes. Oral dietary modification is commonly used in 80% of cases in an effort to provide closure to a leak. The main goal is to decrease production of chyle flow, replenish fluid and electrolyte loss, and prevent malnutrition by the repletion of nutrition stores. This can be done with implementation of a low-fat or fat-free diet (less than 20g fat consumed/day) and MCT oil supplementation. MCT provides the body with a fat that bypasses the lymphatic system, decreasing additional chyle build up. A specialized enteral formula, which contains 100% amino acids and very low fat content -3g fat per 1000mL-, may be indicated with chyle output less than 1000 mL/day. A modified enteral regimen using fat-free oral supplement is an additional intervention which may be a less expensive option than a low fat formula and easier to obtain or purchase. Parenteral nutrition may be indicated providing full caloric support while allowing bowel rest. Bowel rest decreases chyle flow allowing the possibility of healing to occur. Treatment varies depending on the cause or complication severity and patient’s needs. Nutrition therapy and management is an important component in chyle Leak treatment and it is important to evaluate each individual thoroughly in order to determine the best and most successful course of medical nutrition therapy.
During my clinical rotation I was introduced to a new intestinal challenge, a chyle leak. Not many dietetic interns or even Registered Dietitians see this in day-to-day practice due to its very low incidence rate. Throughout my clinical rotation I encountered three patients diagnosed with a chyle Leak and was able to expand my knowledge on the importance of nutrition management and intervention during the time of a chyle leakage. Chyle is a milky-like-fluid consisting of lymph and chylomicrons made in the small intestine during the digestion of dietary content and drained by lacteals into the lymphatic system. One liter contains roughly 200 calories, 20-30g protein, and 5-30 g fat. A chyle leak is a very rare complication most commonly caused by a postoperative complication, nick, or obstruction following abdominal, neck or thoracic surgeries. Nutrition related complications and concerns are: malnutrition- loss of calories, protein, and fat soluble vitamins, and hypovolemia -loss of fluid and electrolytes. Oral dietary modification is commonly used in 80% of cases in an effort to provide closure to a leak. The main goal is to decrease production of chyle flow, replenish fluid and electrolyte loss, and prevent malnutrition by the repletion of nutrition stores. This can be done with implementation of a low-fat or fat-free diet (less than 20g fat consumed/day) and MCT oil supplementation. MCT provides the body with a fat that bypasses the lymphatic system, decreasing additional chyle build up. A specialized enteral formula, which contains 100% amino acids and very low fat content -3g fat per 1000mL-, may be indicated with chyle output less than 1000 mL/day. A modified enteral regimen using fat-free oral supplement is an additional intervention which may be a less expensive option than a low fat formula and easier to obtain or purchase. Parenteral nutrition may be indicated providing full caloric support while allowing bowel rest. Bowel rest decreases chyle flow allowing the possibility of healing to occur. Treatment varies depending on the cause or complication severity and patient’s needs. Nutrition therapy and management is an important component in chyle Leak treatment and it is important to evaluate each individual thoroughly in order to determine the best and most successful course of medical nutrition therapy.
