1. A pulmonologist can be consulted for assistance with high-risk diagnostic thoracentesis, depending on the experience of the clinician.
2. Drainage of complicated effusions usually requires consultation with a pulmonologist, interventional radiologist, or thoracic surgeon, depending on the location of the effusion and the clinical situation.
1. Restrictions of fat intake might be helpful in management of chylous effusions, though management remains controversial.
2. Ongoing drainage of these effusions can rapidly deplete patients of fat and protein stores.
3. Limiting oral fat intake might slow the accumulation of chylous effusions in some patients.
4. Hyperalimentation or total parenteral nutrition can preserve nutritional stores and limit accumulation of the chylous effusion but probably should be restricted to cases where definitive therapy for the underlying cause of the chylous effusion is possible.