OBJECTIVES: We review physiology and pharmacology relating to the use of octreotide for chylothorax in infants and children. We review the published experience of octreotide dosing in this context. DATA SOURCE: Systematic review of the literature, including PubMed (English-only journals), citations from relevant articles, major textbooks, and personal files. CONCLUSIONS: Octreotide has been used as a successful therapeutic adjunct in a small number of neonatal cases and a larger number of pediatric cases. No consensus has been reached as to the optimal route of administration, dose, duration of therapy, or strategy for discontinuation of therapy. We suggest using higher doses (80-100 microg/kg/day) and initiating therapy early rather than using a low initial dose with upward titration. Duration of therapy required to elicit a significant response may vary between patients.
OBJECTIVES: We review physiology and pharmacology relating to the use of octreotide for chylothorax in infants and children. We review the published experience of octreotide dosing in this context. DATA SOURCE: Systematic review of the literature, including PubMed (English-only journals), citations from relevant articles, major textbooks, and personal files. CONCLUSIONS:Octreotide has been used as a successful therapeutic adjunct in a small number of neonatal cases and a larger number of pediatric cases. No consensus has been reached as to the optimal route of administration, dose, duration of therapy, or strategy for discontinuation of therapy. We suggest using higher doses (80-100 microg/kg/day) and initiating therapy early rather than using a low initial dose with upward titration. Duration of therapy required to elicit a significant response may vary between patients.
Authors: Melissa W Landis; Dawn Butler; Foong Yen Lim; Sundeep Keswani; Jason Frischer; Beth Haberman; Paul S Kingma Journal: J Pediatr Surg Date: 2013-11 Impact factor: 2.545