Necrotizing Enterocolitis after Octreotide Treatment in a Preterm Newborn with Idiopathic Congenital Chylothorax

Büyüktiryaki, Mehmet; Öncel, Mehmet Yekta; Okur, Nilüfer; Derme, Turan; Oğuz, Şerife Suna

doi:10.21699/ajcr.v8i5.628

Cited by 2 publications

(2 citation statements)

References 7 publications

(9 reference statements)

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“…Mohseni-Bod et al reported NEC development in term infant with coarctation of the aorta treated with octreotide for postoperative chylothorax 12. Buyuktiryaki et al described NEC development in a preterm infant with congenital chylothorax on day 4 of octreotide administration at 1 µg/kg/hour 13. Our’s is the third case of NEC report in infants treated for chylothorax using octreotide.…”

Section: Discussionmentioning

confidence: 77%

Necrotising enterocolitis in a newborn infant treated with octreotide for chylous effusion: is octreotide safe?

et al. 2020

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Octreotide is a somatostatin analogue used for treating congenital chylothorax and congenital hyperinsulinism in infants. By increasing splanchnic arteriolar resistance and decreasing gastrointestinal blood flow, octreotide indirectly reduces lymphatic flow in chylous effusions.Splanchnic ischaemia following octreotide predisposes infants to necrotising enterocolitis (NEC). Although NEC occurrence in infants treated with octreotide for hyperinsulinaemic hypoglycaemia has been reported widely, its incidence in infants with chylothroax is low. We describe a case of congenital chylothorax in a preterm infant who had poor response to thoracentesis. Although octreotide initiation lead to resolution of chylothorax, he developed NEC. Cessation of octreotide and medical management resulted in rapid resolution of NEC. Since octreotide is generally used as the first-line treatment for chylous effusion, the risk of NEC should be considered, especially when the dosage is increased. Infants on octreotide should be closely observed for early signs and symptoms of NEC to avert surgical emergency.

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Section: Discussionmentioning

confidence: 77%

Necrotising enterocolitis in a newborn infant treated with octreotide for chylous effusion: is octreotide safe?

et al. 2020

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“…Although octreotide is generally well tolerated, it can cause transient changes to blood glucose levels and gastrointestinal symptoms 36. Case reports have associated octreotide with necrotising enterocolitis (NEC) in term and preterm neonates treated for congenital chylothorax 37–39. Therefore, prior to treatment, the risks and benefits needs to be considered and during periods of octreotide treatment, patients should have their blood glucose levels and symptoms of NEC monitored closely.…”

Section: Discussionmentioning

confidence: 99%

Paediatric acute respiratory distress syndrome: consider the role of lymphatics

Cavazzoni

Selvadurai

et al. 2022

BMJ Case Rep

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We present a case of a 7-day-old male infant with severe respiratory disease requiring venoarterial extracorporeal membrane oxygenation therapy with evidence of lymphangiectasia on lung biopsy. Differentiating primary versus secondary lymphangiectasis in this patient remains a riddle despite extensive investigations including an infective screen, lung biopsy and whole-genome sequencing. In addition to the standard therapies used in paediatric acute respiratory distress syndrome, such as lung-protective ventilation, permissive hypoxaemia and hypercarbia, nursing in the prone position, early use of muscle relaxants, rescue intravenous corticosteroids and broad-spectrum antibiotics, the patient was also given octreotide despite the absence of a chylothorax based on the theoretical benefit of altering the lymphatic flow. His case raises an interesting discussion around the role of lymphatics in the pathophysiology of paediatric and adult respiratory distress syndrome and prompts the exploration of novel agents which may affect lymphatic vessels used as an adjunctive therapy.

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Necrotizing Enterocolitis after Octreotide Treatment in a Preterm Newborn with Idiopathic Congenital Chylothorax

Cited by 2 publications

References 7 publications

Necrotising enterocolitis in a newborn infant treated with octreotide for chylous effusion: is octreotide safe?

Necrotising enterocolitis in a newborn infant treated with octreotide for chylous effusion: is octreotide safe?

Paediatric acute respiratory distress syndrome: consider the role of lymphatics

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