title: Octreotide for chylous effusions in congenital diaphragmatic hernia.
abstract: OBJECTIVE
  Chylothorax is a frequent complication in congenital diaphragmatic hernia (CDH) infants and is associated with significant morbidity. The optimal treatment strategy remains unclear. We hypothesize that octreotide decreases chylous effusions in infants with CDH.
  
  
  METHODS
  This is a retrospective study of all infants with CDH admitted to our institution from October 2006 to October 2011.
  
  
  RESULTS
  Eleven (12%) infants developed a chylothorax. Five infants were managed conservatively with thoracostomy and total parenteral nutrition. Six infants were started on octreotide therapy. None of the infants required surgical intervention to stop the effusion. There was no significant difference in survival to discharge, length of stay, or average daily chest tube output between groups. There appeared to be a temporally associated drop in chest tube output upon initiation of octreotide in two infants; however, the overall rate of decline in chest tube drainage was unchanged. In addition, there were infants in the conservative group who demonstrated a similar drop in daily chest tube output despite the absence of octreotide.
  
  
  CONCLUSIONS
  Our data suggest that the majority of chylous effusions in CDH infants resolve with conservative therapy alone.
authors.affiliation: The Perinatal Institute, Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
authors.forename: Melissa W
authors.initials: MW
authors.lastname: Landis
authors.forename: Dawn
authors.initials: D
authors.lastname: Butler
authors.forename: Foong Yen
authors.initials: FY
authors.lastname: Lim
authors.forename: Sundeep
authors.initials: S
authors.lastname: Keswani
authors.forename: Jason
authors.initials: J
authors.lastname: Frischer
authors.forename: Beth
authors.initials: B
authors.lastname: Haberman
authors.forename: Paul S
authors.initials: PS
authors.lastname: Kingma
mesh_terms: D015505:Chest Tubes; D002916:Chylothorax / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D003131:Combined Modality Therapy; D004341:Drug Evaluation; D006548:Hernia, Diaphragmatic / Q000150:complications; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D015282:Octreotide / Q000627:therapeutic use*; D010289:Parenteral Nutrition, Total; D010996:Pleural Effusion / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D013907:Thoracostomy
chemical_list: D015282:Octreotide
keywords: Chylothorax; Congenital diaphragmatic hernia; Octreotide