Bilateral spontaneous chylothorax in a newborn and response to octreotide therapy

Azam, Md. Nawad; Majhi, Subrat Kumar; Mishra, Baikuntha Narayan; Joshi, Ranjit Kumar; Pahi, Prabin Prakash

doi:10.18203/2349-3291.ijcp20170727

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…Therefore, avoiding adverse reactions is a critical point for SST treatment. A starting dosage of 0.5-1.0 μg/kg/hour with an increment of 1-2 μg/kg/hour to a maximum of 10 μg/kg/hour, continuing using for 2-5 weeks was recommended referring to the treatment experience in relevant studies in recent years (7,16,17). SST's treatment in the dosage mentioned above had been observed with better curative efficacy and safety.…”

Section: Discussionmentioning

confidence: 99%

Chemical pleurodesis and somatostatin in treating spontaneous chylothorax in pediatric patients: a retrospective analysis and review of the literature

Long¹,

Cai²,

Deng³

et al. 2020

Transl Pediatr

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Background: Chylothorax is a rare disease, defined as an abnormal accumulation of chylous lymphatic effusion in thoracic cavity, with a high mortality rate in pediatric patients. At present, there are few studies on the treatment of pediatric chylothorax, and conservative treatments like somatostatin (SST) and pleurodesis are performed empirically. SST has been used for treating pediatric chylothorax over 20 years, and povidoneiodine chemical pleurodesis (PICP) is adopted in recent years with a high cure rate, but both the effect are still uncertain. The safety and efficacy of SST and PICP in treating pediatric chylothorax was compared in this study.

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Section: Discussionmentioning

confidence: 99%

Chemical pleurodesis and somatostatin in treating spontaneous chylothorax in pediatric patients: a retrospective analysis and review of the literature

Long¹,

Cai²,

Deng³

et al. 2020

Transl Pediatr

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“…Два метаанализа литературы [19,20] продемонстрировали успех лечения октреотидом, составляющий 70 и 53 % соответственно. Наилучшая эффективность и безопасность этой терапии у взрослых пациентов наблюдалась при использовании концентрации 10 мкг/кг в минуту, что было успешно перенесено на детей [21,22]. Кроме того, октреотид был использован внутривенно в высокой дозировке (20 мкг/кг в час и даже больше) без явных побочных реакций [23,24].…”

Section: дискуссияunclassified

Chemical pleurodesis using povidon-iodine for chylothorax treatment in newborns

Kozlov

Андреевич²,

Распутин

et al. 2020

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

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Introduction. Chylothorax is a rare condition that results from abnormal accumulation of lymphatic fluid in the chest and one of the most common causes of pleural effusion in newborns. The aim of our study is to present our own experience of chemical pleurodesis using povidone-iodine in newborns with chylothorax. Materials and methods. In the present study, we studied data from 10 patients with chylothorax who, over the past years, starting in 2016, underwent chemical pleurodesis using the drug povidone-iodine. Congenital accumulation of lymph in the pleural cavity was recorded in 2 patients, acquired in 8 patients. The indications for this procedure were the absence of response to total parenteral nutrition for at least 10 days and the appointment of octreotide at the maximum dosage. Pleurodesis consisted in the introduction into the pleural cavity of a 4% solution of povidone-iodine with a calculated dose of 1 ml/kg. The povidone-iodine solution was kept inside the pleural cavity for the next 4 hours. Results. Chemical pleurodesis was successfully applied in all 10 patients. In 8 patients, a single prescription of the drug was sufficient, and in 2 remaining patients, the pleurodesis session was repeated. After the procedure of chemical pleurodesis, 2 patients developed respiratory distress syndrome caused by massive atelectasis of the homolateral lung, which was confirmed by X-ray examination. These patients required mechanical ventilation for 24 and 48 hours. The average time for the disappearance of chylothorax was 4 days. In the long-term follow-up, 1 patient died from progressive deterioration of pulmonary function against the background of lung hypoplasia. Conclusions. Our data demonstrate that povidone iodine pleurodesis is a effective treatment for chylothorax in newborns.

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Povidon-iodine applied for the treatment of chylothorax in children

Kozlov

Kovalkov

Poloyan

et al. 2021

Russian Journal of Pediatric Surgery

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Introduction. The aim of this study is to demonstrate the experience of non-surgical treatment of congenital and acquired chylothorax in children using povidone-iodine.Material and methods. The study presents results of treatment of 10 patients with chylothorax who had chemical pleurodesis with povidone-iodine. The study covered a time period from 2016 to 2020. The congenital character of the disease was registered in 2 patients, the acquired one - in 8 patients. The main indication for surgery was ineffective conservative therapy, including the withdrawal of feeding and the administration of preparation Octreotide. The procedure consisted of intrapleural injection of 4% povidone-iodine solution into the pleural cavity with the calculated dose of 1 ml/kg and solution exposure for 4 hours. Results. The interpleural administration of povidone-iodine was effective in all patients. Complications of chemical pleurodesis were observed in 2 patients and were associated with pulmonary edema on the injection side. Lymph outflow was stopped on average in 4 days. There was one adverse episode which developed because of the lung malformation incompatible with life. Conclusions. Intrapleural administration of povidone-iodine is an effective treatment of chylothorax in children.

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Bilateral spontaneous chylothorax in a newborn and response to octreotide therapy

Cited by 3 publications

References 12 publications

Chemical pleurodesis and somatostatin in treating spontaneous chylothorax in pediatric patients: a retrospective analysis and review of the literature

Chemical pleurodesis and somatostatin in treating spontaneous chylothorax in pediatric patients: a retrospective analysis and review of the literature

Chemical pleurodesis using povidon-iodine for chylothorax treatment in newborns

Povidon-iodine applied for the treatment of chylothorax in children

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