Saturday, June 8, 2013

Octreotide for the Management of Chylothorax

Several case reports have shown that octreotide is safe and effective for the management of chylothorax due to various reasons. The property of Octreotide (somatostatin) to induce leak closure is due its decelerating effect on lymph flow, although exact mechanism of action is not well defined.

Treatment usually lasts for 1-2 weeks (mean 11 days). Octreotide may be given subcutaneously at 20 to 70 mcg/kg/day, divided as three doses, or as an IV infusion starting at a dose of 1 to 4 mcg/kg/hr and titrating as needed up to 10 mcg/kg/hr. Infusion can be weaned by the reduction in the volume of pleural drainage.

1. Dalokay Kilic, MD, Octreotide for Treating Chylothorax after Cardiac Surgery - Tex Heart Inst J. 2005; 32(3): 437–439.
2. Kalomenidis I., Octreotide and chylothorax. - Curr Opin Pulm Med. 2006 Jul;12(4):264-7.
3. Cheung Y, Leung MP, Yip M. Octreotide for treatment of postoperative chylothorax. J Pediatr 2001;139:157-9.
4.Rosti L, Bini RM, Chessa M, et al. The effectiveness of octreotide in the treatment of post-operative chylothorax. Eur J Pediatr 2002;161:149-50.
5. Al-Zubairy SA, Al-Jazairi AS. Octreotide as a therapeutic option for management of chylothorax. Ann Pharmacother 2003;37:679-82.

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