title: Is octreotide treatment useful in patients with congenital chylothorax?
abstract: BACKGROUND
  Congenital chylothorax (CC) is a severe congenital disorder characterized by the collection of chyle in the pleural space. Recent case reports suggest that the use of octreotide in the treatment of CC may be useful.
  
  
  OBJECTIVE
  To evaluate the effect of octreotide on pleural effusions in CC.
  
  
  METHODS
  Hospital records of 7 patients with a CC, who were admitted to the Neonatal Intensive Care Unit of the Radboud University Nijmegen Medical Centre between 2006 and 2010 and were treated with octreotide, were retrospectively evaluated.
  
  
  RESULTS
  There was no clear and consistent effect of octreotide treatment on pleural effusions. Pleural effusions eventually decreased in all patients after reaching a dose of 5-6 μg/kg/min, but this could also reflect the natural history of CC. Out of 7 patients, 4 were diagnosed with persistent pulmonary hypertension of the newborn. No other known side effects of octreotide were found. There was a mortality rate of 30%.
  
  
  CONCLUSIONS
  No clear and consistent effect of octreotide was identified. Pulmonary hypertension was a common problem in this patient group. It is not clear whether or not this was caused or maintained by octreotide treatment. A randomized controlled trial is needed to investigate the safety and usefulness of octreotide. Until then, clinicians should be careful in using octreotide, especially when persistent pulmonary hypertension is present.
authors.affiliation: Department of Paediatrics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Maud
authors.initials: M
authors.lastname: Horvers
authors.forename: Christiaan F
authors.initials: CF
authors.lastname: Mooij
authors.forename: Timothy A J
authors.initials: TA
authors.lastname: Antonius
mesh_terms: D000328:Adult; D002916:Chylothorax / Q000150:complications / Q000151:congenital* / Q000188:drug therapy / Q000401:mortality; D000075202:Contraindications; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D005865:Gestational Age; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D009426:Netherlands / Q000453:epidemiology; D015282:Octreotide / Q000627:therapeutic use*; D010996:Pleural Effusion / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D011247:Pregnancy; D011296:Prenatal Diagnosis; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D005765:Gastrointestinal Agents; D015282:Octreotide