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. 2019 Sep-Oct;24(5):406-415.
doi: 10.5863/1551-6776-24.5.406.

Evaluating the Use of Octreotide for Acquired Chylothorax in Pediatric Critically Ill Patients Following Cardiac Surgery

Annie Bui, Courtney J Long, Robin L Breitzka, Joshua S Wolovits

Evaluating the Use of Octreotide for Acquired Chylothorax in Pediatric Critically Ill Patients Following Cardiac Surgery

Annie Bui et al. J Pediatr Pharmacol Ther. 2019 Sep-Oct.

Abstract

Objectives: To evaluate the impact of octreotide on time to resolution of chylothorax compared with conventional therapy. Secondary outcomes include the following: time to reduction of chest tube output by 20%, additional surgeries for chylothorax, hospital length of stay, in-hospital mortality, and adverse drug reactions.

Methods: We retrospectively evaluated the efficacy of octreotide vs conventional therapy for treatment postoperative chylothorax in pediatric patients in the cardiac ICU following surgery for congenital heart disease between October 2008 and June 2017.

Results: Final analysis included 32 patients with chylothorax who met inclusion criteria. Patients who received octreotide had a longer duration of chest tube drainage than those who received conventional therapy (24 vs 9 days, p < 0.001). Resolution of chylothorax was achieved in 13 of 16 (81.3%) octreotide patients and 16 of 16 (100%) conventional patients (p = 0.178). There was a comparable time to reduction by 20% in drainage (6 vs 8 days, p = 0.337). There was no significant correlation between time after starting conventional management and reduction chylous output in either the octreotide or conventional therapy group (p = 0.809, p = 0.107, respectively). However, there was a significant and moderate correlation between octreotide and reduction in a chylous output following initiation of octreotide (R 2 = 0.464, p = 0.021).

Conclusions: Octreotide is potentially a safe and effective therapy for treatment in pediatric patients with refractory chylothorax following surgery for congenital heart disease.

Keywords: acquired chylothorax; chylothorax; congential heart disease; octreotide; pediatric; refractory chylothorax.

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Conflict of interest statement

Disclosure The authors declare no conflicts or financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts, and honoraria. The authors had full access to all data and take responsibility for the integrity and accuracy of the data analysis.

Figures

Figure 1.
Figure 1.
Study design.
Figure 2.
Figure 2.
Distribution of admission dates between the octreotide and conventional therapy groups (n = 32).
Figure 3.
Figure 3.
Median daily chest tube drainage of 32 patients after conventional management was started in both the octreotide group (before octreotide was started) and conventional therapy group.
Figure 4.
Figure 4.
Median daily chest tube drainage of 16 patients after starting octreotide therapy.
See this image and copyright information in PMC

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