Octreotide and chylothorax

Q: How does octreotide help in the management of chylothorax?

Answer: By decreasing intestinal fat absorption

Chylothorax continues to remain a challenging situation for both traumatic, including post-surgical, as well as non-traumatic etiologies. Various dietary, surgical, and pharmacological interventions have been tried with varying degrees of success.

Somatostatin analogs such as octreotide and lanreotide are known to decrease intestinal fat absorption. A short course of subcutaneous (SQ) octreotide, 50 to 200 micrograms every 8 hours for 1 to 2 weeks, has been proposed by experts, with caution to discontinue after 2 weeks regardless of the response. 

Caution should be exercised to monitor for cutaneous flushing, nausea, diarrhea, sinus bradycardia, injection-site pain, and elevated liver function tests.

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References:

1. Mincher L, Evans J, Jenner MW, Varney VA. The successful treatment of chylous effusions in malignant disease with octreotide. Clin Oncol (R Coll Radiol) 2005; 17:118.

2. Evans J, Clark MF, Mincher L, Varney VA. Chylous effusions complicating lymphoma: a serious event with octreotide as a treatment option. Hematol Oncol 2003; 21:77.

3. Kalomenidis I. Octreotide and chylothorax. Curr Opin Pulm Med. 2006 Jul;12(4):264-7. doi: 10.1097/01.mcp.0000230629.73139.26. PMID: 16825878.