Is Octreotide Treatment Useful in Patients with Congenital Chylothorax?

Horvers, M.; Mooij, Christiaan F.; Antonius, Tim

doi:10.1159/000330413

Cited by 29 publications

(24 citation statements)

References 41 publications

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“…Enteral nutrition with medium-chain triglycerides and total parenteral nutrition have been successfully employed. In this case, the parenteral nutrition was not possible due to shortage in the pharmacy of the hospital [10] [11].…”

Section: Discussionmentioning

confidence: 98%

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Congenital Chylothorax: Rapid and Effective Response to Polyvidone Iodine

Maoulainine¹,

Slitine²,

Erguig³

2016

OJPed

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Introduction: Congenital chylothorax, defined by the presence of chyle in the pleural cavity, is a rare congenital disorder of varying severity. The objective of this study was to report a case of idiopathic congenital chylothorax treated with povidone iodine effectively without side effects after failure of conservative treatment by chest drainage. Case presentation: A term female Newborn was admitted in the neonatal intensive care unit at 16 days of life, for respiratory distress. The Clinical examination objectified a Sliverman score of 3/10 with a pleural effusion syndrome. The chest radiography confirmed the pleural effusion and the analysis of the pleural fluid after aspiration confirmed the chylothorax, with a protein rate of 35 g/l, Triglycerids 37 mg/L, and Leukocytes count was 1140/ml with 90% lymphocytes. A chest drainage was performed on the seventh day but followed by the recurrence of the effusion. The use of 5 ml of 4% povidone iodine in the pleural space as a chemical pleurodesis was performed. The clinical and radiological evolution was favorable after 24 hours without relapse or side effects such as allergic reaction or worsening of the respiratory condition. Thoracic ultrasound was performed after 15 days, having objectified minimal right side effusion measuring 5 mm maximum thickness. Conclusion: Chemical pleurodesis by the polyvidone iodine in the chylothorax appears to be affordable and effective, and needs to be more considerate in the conservative treatment of congenital chylothorax.

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Section: Discussionmentioning

confidence: 98%

“…Nutrition plays an important role in reducing lymphatic production [10]. Enteral nutrition with medium-chain triglycerides and total parenteral nutrition have been successfully employed.…”

Section: Discussionmentioning

confidence: 99%

Congenital Chylothorax: Rapid and Effective Response to Polyvidone Iodine

Maoulainine¹,

Slitine²,

Erguig³

2016

OJPed

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“…No practice recommendation was made based on this evidence. Horvers et al 124 reported on the use of octreotide in 7 patients with congenital chylothorax. Pleural effusions eventually decreased in all patients after administration of 5 to 6 mg octreotide/kg per minute, but the authors felt that the decrease might reflect the natural history of congenital chylothorax and, hence, no clear, consistent effect of octreotide was identified.…”

Section: Figurementioning

confidence: 99%

“…A randomized, controlled, multicenter trial is needed to assess the safety and efficacy of octreotide and somatostatin use in the treatment of chylothorax in children. 123,124 Other agents used in the treatment of chylothorax include nitric oxide and etilefrine. A case report described the use of nitric oxide in a neonate who developed a chylothorax after surgery for congenital heart disease.…”

Section: Figurementioning

confidence: 99%

Chylothorax in Infants and Children

2014

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Chylothorax, the accumulation of chyle in the pleural space, is a relatively rare cause of pleural effusion in children. It can cause significant respiratory morbidity, as well as lead to malnutrition and immunodeficiency. Thus, a chylothorax requires timely diagnosis and treatment. This review will first discuss the anatomy and physiology of the lymphatic system and discuss various causes that can lead to development of a chylothorax in infants and children. Then, methods of diagnosis and treatment will be reviewed. Finally, complications of chylothorax will be reviewed. Pediatrics 2014;133:722-733

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“…Given subcutaneously or intravenously it is thought to have a direct effect on the vascular somatostatin receptor level with vasoconstriction of the splanchnic circulation, thereby decreasing chyle production, intestinal lymphatic volume and flow in the thoracic duct [60]. Treatment trials with Octreotide for patients with CPL and CC are only reported in uncontrolled case studies [41,[60][61][62] with no clear and consistent effect on pleural effusions. Adverse side effects like gastrointestinal intolerance or transient hypothyroidism have to be considered.…”

Section: Therapeutic Optionsmentioning

confidence: 99%