Octreotide for congenital and acquired chylothorax in newborns: A systematic review

Carlo Bellini, Rita Cabano, Laura C. De Angelis, Tommaso Bellini, Maria G. Calevo, Paolo Gandullia, Luca A. Ramenghi

Research output: Contribution to journalArticle

Abstract

Aim: Chylothorax is a rare but life-threatening condition in newborns. Octreotide, a somatostatin analogue, is widely used as a therapeutic option in neonates with congenital and acquired chylothorax, but its therapeutic role has not been clarified yet. Methods: We performed a systematic review to assess the efficacy and safety of octreotide in the treatment of congenital and acquired chylothorax in newborns. Comprehensive research, updated till 31 October 2017, was performed by searching in PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) databases using the MeSH terms ‘octreotide’ and ‘chylothorax’. Both term and preterm newborns with congenital or acquired chylothorax treated with octreotide within the 30th day of life were included. Octreotide treatment was considered effective if a progressive reduction/ceasing in drained chylous effusion occurred. Results: A total of 39 articles were included. Octreotide was effective in 47% of patients, with a slight but not significant difference between congenital (30/57; 53.3%) and acquired (9/27; 33.3%) chylothorax (P = 0.10). Marked variation in octreotide regimen was observed. The most common therapeutic scheme was intravenous infusion at a starting dose of 1 μg/kg/h, gradually increasing to 10 μg/kg/h according to the therapeutic response. Side effects were reported in 12 of 84 patients (14.3%). Only case reports were included in this review due to the lack of randomised controlled trials. Conclusion: Octreotide is a relatively effective and safe treatment option in neonates with chylothorax, especially for the congenital forms.

Original languageEnglish
Pages (from-to)840-847
Number of pages8
JournalJournal of Paediatrics and Child Health
Volume54
Issue number8
DOIs
Publication statusPublished - Aug 1 2018

Keywords

  • chylothorax
  • infant
  • newborn
  • octreotide

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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