Octreotide in the treatment of neonatal postoperative chylothorax: report of three cases and literature review

Abstract

Chylothorax is a well-recognized complication after neonatal cardiothoracic surgery. Management strategies include cessation of enteral feedings, repeated aspiration, chest drainage, and total parenteral nutrition. Somatostatin and its analogue, octreotide, have been used with promising results. The authors present three cases of neonatal postoperative chylothorax in which octreotide was used. After literature review, we can say that octreotide is relatively safe, and may reduce clinical course and complications associated with neonatal postoperative chylothorax. One should be aware of possible association between octreotide and necrotizing enterocolitis. Prospective controlled trials supporting octreotide use are lacking.

Use of octeriotide in the management of neonatal Chylothorax secondary to repair of congenital diaphragmatic hernia: A report of two cases and review of literature

“…[12] The results, as expected, were very variable. Based on these studies we constructed Table 1 which shows a summary of therapeutic regimens of Octeriotide in postoperative chylothorax following surgery for congenital diaphragmatic hernia.…”

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

“…Octreotide indeed causes a significant degree of diminished blood flow on celiac, superior and inferior mesenteric artery. [8] In conclusion, premature newborns on octreotide treatment for congenital chylothorax are at high risk for NEC development and should be carefully monitored. On suspicion the therapy should be discontinued as we did in our patient.…”

Treatment of chylothorax developed after congenital heart disease surgery: a case report

“…Optimal timing and dose of these two drugs have not been known so far [12]. Though duration of treatment is controversial, generally treatment should be continued for 3–5 days after cessation of the drainage of the pleural fluid [8, 16]. During treatment with octreotide and somotatin adverse effects as hyperglycemia, hypothyroidism, muscle cramps, hypertension, nausea, diarrhea, necrotizing enterocolitis, renal involvement and hepatic dysfunction can be encountered [17].…”