Is octreotide a risk factor in necrotizing enterocolitis?

Reck-Burneo, Carlos A.; Parekh, Aruna; Velcek, Francisca T.

doi:10.1016/j.jpedsurg.2008.02.062

Cited by 32 publications

(24 citation statements)

References 6 publications

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“…Although we did not find any of the more commonly reported side effects like severe gastrointestinal problems (for example, necrotizing enterocolitis) [19] , hypothyroidism, cholelithiasis [20,21] and retinal problems [22,23] , we did find a relatively high occurrence of PPHN which required treatment.…”

Section: Discussioncontrasting

confidence: 77%

Is Octreotide Treatment Useful in Patients with Congenital Chylothorax?

2011

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Background: Congenital chylothorax (CC) is a severe congenital disorder characterized by the collection of chyle in the pleural space. Recent case reports suggest that the use of octreotide in the treatment of CC may be useful. Objective: To evaluate the effect of octreotide on pleural effusions in CC. Methods: Hospital records of 7 patients with a CC, who were admitted to the Neonatal Intensive Care Unit of the Radboud University Nijmegen Medical Centre between 2006 and 2010 and were treated with octreotide, were retrospectively evaluated. Results: There was no clear and consistent effect of octreotide treatment on pleural effusions. Pleural effusions eventually decreased in all patients after reaching a dose of 5–6 µg/kg/min, but this could also reflect the natural history of CC. Out of 7 patients, 4 were diagnosed with persistent pulmonary hypertension of the newborn. No other known side effects of octreotide were found. There was a mortality rate of 30%. Conclusions: No clear and consistent effect of octreotide was identified. Pulmonary hypertension was a common problem in this patient group. It is not clear whether or not this was caused or maintained by octreotide treatment. A randomized controlled trial is needed to investigate the safety and usefulness of octreotide. Until then, clinicians should be careful in using octreotide, especially when persistent pulmonary hypertension is present.

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Section: Discussioncontrasting

confidence: 77%

Is Octreotide Treatment Useful in Patients with Congenital Chylothorax?

2011

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“…Two case reports described NEC occurring within 72 hours after octreotide initiation. The first was an infant with 2600 g birth weight who received octreotide for treatment of chylothorax diagnosed two weeks after a coarctation repair; the second, a 22-day-old, full-term infant who received octreotide for persistent hypoglycemia treatment [22,39]. However there is a concern that octreotide may be associated with NEC, we observed an incidence of only 2% (10/428) of NEC in our infants exposed to octreotide, which is similar to a previously described cohort of hospitalized infants (1.2% [6460/560,227]) [35].…”

Section: Discussionmentioning

confidence: 99%

Safety of octreotide in hospitalized infants

Testoni

Hornik

Neely

et al. 2015

Early Human Development

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Background Octreotide is used off-label in infants for treatment of chylothorax, congenital hyperinsulinism, and gastrointestinal bleeding. The safety profile octreotide in hospitalized infants has not been described; we sought to fill this information gap. Methods We identified all infants exposed to at least 1 dose of octreotide from a cohort of 887,855 infants discharged from 333 neonatal intensive care units managed by the Pediatrix Medical Group between 1997 and 2012. We collected laboratory and clinical information while infants were exposed to octreotide and described the frequency of baseline diagnoses, laboratory abnormalities, and adverse events (AEs). Results A total of 428 infants received 490 courses of octreotide. The diagnoses most commonly associated with octreotide use were chylothorax (50%), pleural effusion (32%), and hypoglycemia (22%). The most common laboratory AEs that occurred during exposure to octreotide were thrombocytopenia (47/1000 infant-days), hyperkalemia (21/1000 infant-days), and leukocytosis (20/1000 infant-days). Hyperglycemia occurred in 1/1000 infant-days and hypoglycemia in 3/1000 infant-days. Hypotension requiring pressors (12%) was the most common clinical AE that occurred during exposure to octreotide. Necrotizing enterocolitis was observed in 9/490 (2%) courses, and death occurred in 11 (3%) infants during octreotide administration. Conclusion Relatively few AEs occurred during off-label use of octreotide in this cohort of infants. Additional studies are needed to further evaluate the safety, dosing, and efficacy of this medication in infants.

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“…Necrotizing enterocolitis has also been reported and is a potentially fatal side-effect of octreotide. 14,15 In the reports cited in Table 1, the most common sideeffect was transient abdominal distention. However, because of the lack of reports in the literature, the longterm safety and adverse effects are not well known.…”

Section: Discussionmentioning

confidence: 99%

Treatment of congenital chylothorax with octreotide in a hydropic preterm infant

Choo

Lim

2013

Paediatrics and International Child Health

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Congenital chylothorax is rare in preterm infants. While most cases respond to conservative treatment, a few require surgery. Treatment with intravenous octreotide has been reported to have varying success in preterm infants. A fetus was diagnosed with bilateral hydrothoraces at 29 weeks of gestation and repeated thoracocentesis was performed antenatally to allow growth of the lungs. She was delivered electively at 32 weeks by caesarean section. Hydrops fetalis was confirmed and chest tubes were inserted bilaterally soon after birth. Intravenous octreotide was commenced on day 4 of life, titrated to a maximum of 10 μg/kg/hr for a total of 28 days. Hydrothorax resolved at day 30 and total parenteral nutrition was given for a total of 37 days. She was successfully extubated on day 40 of life and discharged on day 80. On review at 6 months of age, she was thriving and developing normally.

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Is octreotide a risk factor in necrotizing enterocolitis?

Cited by 32 publications

References 6 publications

Is Octreotide Treatment Useful in Patients with Congenital Chylothorax?

Is Octreotide Treatment Useful in Patients with Congenital Chylothorax?

Safety of octreotide in hospitalized infants

Treatment of congenital chylothorax with octreotide in a hydropic preterm infant

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