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

Research output: Contribution to journalArticle

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 (R2 = 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.

Original languageEnglish (US)
Pages (from-to)406-415
Number of pages10
JournalJournal of Pediatric Pharmacology and Therapeutics
Volume24
Issue number5
DOIs
StatePublished - Sep 1 2019

Fingerprint

Chylothorax
Octreotide
Critical Illness
Thoracic Surgery
Pediatrics
Chest Tubes
Drainage
Heart Diseases
Length of Stay
Therapeutics
Group Psychotherapy
Hospital Mortality
Drug-Related Side Effects and Adverse Reactions

Keywords

  • Acquired chylothorax
  • Chylothorax
  • Congential heart disease
  • Octreotide
  • Pediatric
  • Refractory chylothorax

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pharmacology (medical)

Cite this

Evaluating the use of octreotide for acquired chylothorax in pediatric critically ill patients following cardiac surgery. / Bui, Annie; Long, Courtney J.; Breitzka, Robin L.; Wolovits, Joshua S.

In: Journal of Pediatric Pharmacology and Therapeutics, Vol. 24, No. 5, 01.09.2019, p. 406-415.

Research output: Contribution to journalArticle

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AB - 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 (R2 = 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.

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