BACKGROUND/ PURPOSE: 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.
BACKGROUND/ PURPOSE: 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: M N Hanekamp; G C M Tjin A Djie; W G van Hoek-Ottenkamp; F W J Hazebroek; D Tibboel; R R Postema Journal: J Pediatr Surg Date: 2003-06 Impact factor: 2.545
Authors: Raquel Gonzalez; Benjamin S Bryner; Daniel H Teitelbaum; Ronald B Hirschl; Robert A Drongowski; George B Mychaliska Journal: J Pediatr Surg Date: 2009-06 Impact factor: 2.545
Authors: Nikoletta R Czobor; György Roth; Zsolt Prodán; Daniel J Lex; Erzsébet Sápi; László Ablonczy; Mihály Gergely; Edgar A Székely; János Gál; Andrea Székely Journal: J Thorac Dis Date: 2017-08 Impact factor: 2.895