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Effects of somatostatin/octreotide treatment in neonates with congenital chylothorax.

Abstract The influence of somatostatin/octreotide treatment on outcomes of neonates with congenital chylothorax remains controversial. We retrospectively reviewed our experience with somatostatin/octreotide therapy in neonates with this very rare disease.Fourteen neonates with congenital chylothorax who were treated with somatostatin (3.5-7 μg/kg/h, before 2016) or octreotide (1-6 μg/kg/h, after January 2016), along with traditional management between 2013 and 2016, were retrospectively reviewed in this observational study. Their daily volumes of pleural drainage and parameters of respiratory support were recorded, and the potential side effects of somatostatin/octreotide were screened.Four patients (28.6%) had a unilateral presentation of pleural effusion, whereas 10 patients (71.4%) had a bilateral presentation. Twelve patients (85.7%) survived until discharge without later recurrence or death, whereas 2 patients (14.3%) died within the first 3 days after birth. Somatostatin/octreotide treatment was maintained for a median period of 6 days (range 1-16 days). The chest tube was removed after a median duration of 14 days (range 2-51 days), and no patient needed pleurodesis or thoracic duct ligation surgery. The average daily drain output within 3 days post-treatment (median 62 mL, range 10-651 mL) was significantly lower than that before treatment (median 133 mL, range 70-620 mL) (P = .002). The need for ventilation support was reduced in most patients (85.7%) after the initiation of somatostatin/octreotide therapy. No serious side effects were identified.Somatostatin/octreotide treatment reduced pleural drainage and respiratory support without significant side effects. Further randomized controlled studies with more patients are necessary to ascertain the benefits of somatostatin/octreotide in neonates with congenital chylothorax.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28723800
OWN - NLM
STAT- MEDLINE
DA  - 20170720
DCOM- 20170808
LR  - 20170808
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 29
DP  - 2017 Jul
TI  - Effects of somatostatin/octreotide treatment in neonates with congenital
      chylothorax.
PG  - e7594
LID - 10.1097/MD.0000000000007594 [doi]
AB  - The influence of somatostatin/octreotide treatment on outcomes of neonates with
      congenital chylothorax remains controversial. We retrospectively reviewed our
      experience with somatostatin/octreotide therapy in neonates with this very rare
      disease.Fourteen neonates with congenital chylothorax who were treated with
      somatostatin (3.5-7 mug/kg/h, before 2016) or octreotide (1-6 mug/kg/h, after
      January 2016), along with traditional management between 2013 and 2016, were
      retrospectively reviewed in this observational study. Their daily volumes of
      pleural drainage and parameters of respiratory support were recorded, and the
      potential side effects of somatostatin/octreotide were screened.Four patients
      (28.6%) had a unilateral presentation of pleural effusion, whereas 10 patients
      (71.4%) had a bilateral presentation. Twelve patients (85.7%) survived until
      discharge without later recurrence or death, whereas 2 patients (14.3%) died
      within the first 3 days after birth. Somatostatin/octreotide treatment was
      maintained for a median period of 6 days (range 1-16 days). The chest tube was
      removed after a median duration of 14 days (range 2-51 days), and no patient
      needed pleurodesis or thoracic duct ligation surgery. The average daily drain
      output within 3 days post-treatment (median 62 mL, range 10-651 mL) was
      significantly lower than that before treatment (median 133 mL, range 70-620 mL)
      (P = .002). The need for ventilation support was reduced in most patients (85.7%)
      after the initiation of somatostatin/octreotide therapy. No serious side effects 
      were identified.Somatostatin/octreotide treatment reduced pleural drainage and
      respiratory support without significant side effects. Further randomized
      controlled studies with more patients are necessary to ascertain the benefits of 
      somatostatin/octreotide in neonates with congenital chylothorax.
FAU - Yin, Rong
AU  - Yin R
AD  - Department of Neonatology, Children's Hospital of Fudan University, Shanghai,
      China.
FAU - Zhang, Rong
AU  - Zhang R
FAU - Wang, Jin
AU  - Wang J
FAU - Yuan, Lin
AU  - Yuan L
FAU - Hu, Liyuan
AU  - Hu L
FAU - Jiang, Siyuan
AU  - Jiang S
FAU - Chen, Chao
AU  - Chen C
FAU - Cao, Yun
AU  - Cao Y
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Hormones)
RN  - 51110-01-1 (Somatostatin)
RN  - RWM8CCW8GP (Octreotide)
RN  - Chylothorax, congenital
SB  - AIM
SB  - IM
MH  - Chest Tubes
MH  - Chylothorax/*congenital/therapy
MH  - Female
MH  - Hormones/*therapeutic use
MH  - Humans
MH  - Infant, Newborn
MH  - Length of Stay
MH  - Male
MH  - Octreotide/*therapeutic use
MH  - Pleural Effusion/drug therapy
MH  - Respiration, Artificial
MH  - Retrospective Studies
MH  - Somatostatin/*therapeutic use
MH  - Treatment Outcome
PMC - PMC5521940
EDAT- 2017/07/21 06:00
MHDA- 2017/08/09 06:00
CRDT- 2017/07/21 06:00
AID - 10.1097/MD.0000000000007594 [doi]
AID - 00005792-201707210-00065 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jul;96(29):e7594. doi: 10.1097/MD.0000000000007594.