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Use of octreotide in the treatment of chylothorax and chyloperitoneum
Cristiane Felix Ximenes Pessotti1, Ieda Biscegli Jatene, Paulo Emanuel Uhrovcik Buononato
1Hospital do Coração, Associação do Sanatório Sírio, São Paulo, SP, Brazil. crisximenes08@gmail.com
Insights
Octreotide effectively treated chylothorax and chylous ascites in children post-cardiac surgery when standard treatments failed. This approach led to improved outcomes without significant adverse effects.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Cardiology
Background:
- Chylothorax and chylous ascites are rare but serious complications following pediatric cardiac surgery.
- Conventional management, including fasting and parenteral nutrition, is often insufficient for refractory cases.
Observation:
- Three pediatric patients with post-cardiac surgery chylothorax and one with chylous ascites presented with persistent lymphatic fluid leakage.
- These cases did not respond to standard clinical treatments.
Findings:
- Treatment with octreotide, initiated at 1.0 mcg/kg/h and titrated up to 4.0 mcg/kg/h, demonstrated a favorable response in all patients.
- A gradual reduction in lymphatic drainage and overall clinical improvement were observed.
- No significant side effects were reported during octreotide administration.
Implications:
- Octreotide represents a viable and safe therapeutic option for managing refractory chylothorax and chylous ascites in pediatric patients after cardiac surgery.
- This finding may guide clinical practice towards earlier consideration of octreotide in similar challenging cases.
- Further research could explore optimal dosing and long-term efficacy.
Abstract:
Report of three cases of chylothorax and one case of chylous ascites in children who had undergone cardiac surgery with no response to routine clinical treatment, based on fasting and long-term parenteral nutrition. Treatment with octreotide at an initial dose of 1.0 mcg/kg/h was chosen, with a gradual increase of 1.0 mcg/kg/hr/day until a maximum dose of 4.0 mcg/kg/h. All cases had a favorable response, with gradual reduction of drainage output until prognosis improvement with no significant side effects.