Octreotide in Pediatric Patients

Heikenen, Janice B.; Pohl, John F.; Werlin, Steven L.; Bucuvalas, John C.

doi:10.1097/00005176-200211000-00003

Cited by 49 publications

(35 citation statements)

References 113 publications

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“…11 Although the use of octreotide in children is currently off-label, it is being increasingly used in several GI conditions, such as pancreatitis, diarrhea, esophageal varices, and acute and chronic gastrointestinal bleeding. 12,13 The use of octreotide in newborns has also increased over the past decade. The most common indication is chylothorax 7 as, by decreasing intestinal fat absorption, octreotide contributes to the reduction of lymphatic flow in the thoracic duct.…”

Section: Discussionmentioning

confidence: 99%

“…Although there is agreement that continuous infusion is the preferred method for octreotide administration, a wide range of the daily dose has been reported. 7,12,18 The dosage used in the current study was relatively low, and was chosen taking into account the infant's critical condition, low weight, and gestational age, all of which could affect drug metabolism.…”

Section: Discussionmentioning

confidence: 99%

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Octreotide in a Critically Ill Extremely Preterm Infant With Perforated Necrotizing Enterocolitis

et al. 2016

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Necrotizing enterocolitis (NEC) is the most severe gastrointestinal complication of prematurity. Surgery, either peritoneal drainage placement or laparotomy with resection of the intestinal necrotic tracts, is the definitive treatment of perforated NEC; however, when clinical conditions contraindicate surgical approaches, little is known about medical treatments adjuvant or alternative to surgery. Octreotide is a synthetic somatostatin analog that inhibits pancreatic secretion and leads to splanchnic vasoconstriction. In preterm neonates, it is mainly used off-label for chylothorax and congenital hyperinsulinism, whereas gastrointestinal indications are limited. We describe the case of a critically ill extremely low birth weight infant with perforated NEC, who had unsuccessfully undergone peritoneal drainage placement and laparotomy. Her unstable condition contraindicated a further laparotomy, thus off-label treatment with octreotide was attempted. No adverse events occurred. The infant’s condition gradually improved and progressive reduction of peritoneal outputs and successful resolution of pneumoperitoneum were achieved, with no relapse after octreotide discontinuation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Octreotide in a Critically Ill Extremely Preterm Infant With Perforated Necrotizing Enterocolitis

et al. 2016

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“…Oct treatment is associated with known side effects (30). Prolonged Oct treatment decreases insulin secretion and causes impaired glucose tolerance.…”

Section: Discussionmentioning

confidence: 99%

Long-acting octreotide treatment causes a sustained decrease in ghrelin concentrations but does not affect weight, behaviour and appetite in subjects with Prader–Willi syndrome

Waele

Ishkanian

Bogarin

et al. 2008

European Journal of Endocrinology

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Objective: Ghrelin is secreted primarily by the stomach and circulates as both acylated and desacyl ghrelin. Acylated (but not desacyl) ghrelin stimulates appetite. Both concentrations are elevated in Prader-Willi syndrome (PWS), suggesting that ghrelin may contribute to hyperphagia and overweight in these subjects. We evaluated whether long-acting octreotide (Oct) decreases acylated and desacyl ghrelin concentrations, body mass, appetite and compulsive behaviour towards food in adolescents with PWS. Design: A 56-week prospective, randomized, cross-over trial. Methods: Nine subjects with PWS (age 14.6 (10.8-18.9) years, body mass index (BMI) Z-score C1.9 (0.6-3.0)) received either Oct (30 mg) or saline i.m. every 4 weeks for 16 weeks and were switched over to the other treatment after a 24-week washout period. Results: Eight subjects completed the study. Oct caused a decrease in both acylated (K53%) and desacyl (K54%) fasting ghrelin concentrations (P!0.05) but did not significantly affect BMI. Oct had no significant effect on peptide YY concentrations, appetite or compulsive behaviour towards food. Oct caused a decrease in insulin-like growth factor-I concentrations, an increase in HbA1c and transient elevation of blood glucose in two subjects. Three subjects developed gallstones. Conclusions: Oct treatment caused a prolonged decrease in ghrelin concentrations in adolescents with PWS but did not improve body mass or appetite. Future intervention studies aiming at clarifying the role of ghrelin in PWS should focus on the administration of specific inhibitors of ghrelin secretion or ghrelin receptor activity that do not interfere with other appetite-regulating peptides.

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“…It can be administered subcutaneously or as a continuous intravenous infusion and has been used for treatment of gastrointestinal hemorrhage, intractable diarrhea, pancreatitis and endocrine tumors of the gastrointestinal tract [14,15]. There are two reports of its use in treating chylous ascites in children but none in children with ESRD on peritoneal dialysis [16,17].…”

Section: Discussionmentioning

confidence: 99%

Recurrent chyloperitoneum—a rare complication of peritoneal dialysis

et al. 2008

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We report the spontaneous development of recurrent chyloperitoneum as a complication of peritoneal dialysis in a toddler. An 18-month-old boy with end-stage renal disease (ESRD) on continuous cycling peritoneal dialysis developed spontaneous chyloperitoneum. He was treated conservatively, with a low-fat diet supplemented with medium-chain triglycerides. The chyloperitoneum resolved within 2 days of his being on the low-fat diet, but it recurred after re-institution of regular feeds on four occasions. After 3 months, the chyle leak finally resolved after an extended period of low-fat feeds. Chyloperitoneum is a rare complication of peritoneal dialysis that can be confused with signs of peritonitis, and it is important to differentiate between the two so that appropriate management can be undertaken. This paper discusses the possible causes, management and complications of recurrent chyloperitoneum.

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Octreotide in Pediatric Patients

Cited by 49 publications

References 113 publications

Octreotide in a Critically Ill Extremely Preterm Infant With Perforated Necrotizing Enterocolitis

Octreotide in a Critically Ill Extremely Preterm Infant With Perforated Necrotizing Enterocolitis

Long-acting octreotide treatment causes a sustained decrease in ghrelin concentrations but does not affect weight, behaviour and appetite in subjects with Prader–Willi syndrome

Recurrent chyloperitoneum—a rare complication of peritoneal dialysis

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