title: Octreotide treatment of chylothorax in pediatric patients following cardiothoracic surgery.
abstract: OBJECTIVE
  To analyze the efficacy and safety of octreotide treatment of persistent chylothorax in pediatric patients following cardiothoracic surgery.
  
  
  METHODS
  Retrospective chart review of patients admitted to the cardiac intensive care unit of a tertiary care center over a 10-year period (1998-2008). Nineteen patients were identified who underwent treatment with octreotide for persistent chylothorax following cardiothoracic surgery. We analyzed data regarding age, sex, type of cardiac lesion and surgical procedure, postoperative day octreotide therapy was initiated, maximum drainage prior to and during octreotide therapy, dose range of octreotide, days to resolution, and complications.
  
  
  RESULTS
  Twelve patients (63%) experienced resolution of their chylothorax during octreotide treatment. Fourteen patients (74%) demonstrated a decrease in the peak effusion drainage rate following initiation of octreotide therapy, though two of these patients ultimately required further surgical intervention to achieve resolution. Octreotide treatment was associated with unchanged or increased effusion drainage rate in four patients (21%). Patients that responded to octreotide had a lower mean maximal drainage prior to octreotide initiation. Two patients experienced side effects temporally associated with octreotide therapy (transient hypoglycemia and diarrhea). No serious side effects were identified.
  
  
  CONCLUSIONS
  Octreotide treatment of chylothorax in combination with dietary modifications in pediatric patients following cardiothoracic surgery resulted in a reduction of peak effusion drainage and eventual resolution in the majority of cases with few and transient side effects.
authors.affiliation: Department of Pediatrics, Division of Pediatric Cardiology, The Children's Hospital and The University of Colorado, The University of Colorado, Denver, Colo 80045, USA.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Caverly
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Rausch
authors.forename: Eduardo
authors.initials: E
authors.lastname: da Cruz
authors.forename: Jon
authors.initials: J
authors.lastname: Kaufman
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002675:Child, Preschool; D002916:Chylothorax / Q000188:drug therapy* / Q000209:etiology; D003120:Colorado; D003131:Combined Modality Therapy; D018752:Diet, Fat-Restricted; D004322:Drainage; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D018529:Nutritional Support; D015282:Octreotide / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D019616:Thoracic Surgical Procedures / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015282:Octreotide