Octreotide for the treatment of chylothorax in neonates.

Hdl Handle:
http://hdl.handle.net/10147/207961
Title:
Octreotide for the treatment of chylothorax in neonates.
Authors:
Das, Animitra; Shah, Prakeshkumar S
Affiliation:
Department of Pediatrics, Waterford Regional Hospital, Dunmore Road, Waterford,, Ireland.
Citation:
Cochrane Database Syst Rev. 2010 Sep 8;(9):CD006388.
Journal:
Cochrane database of systematic reviews (Online)
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207961
DOI:
10.1002/14651858.CD006388.pub2
PubMed ID:
20824848
Abstract:
BACKGROUND: Routine care for chylothorax in neonate includes either conservative or surgical approaches. Octreotide, a somatostatin analogue, has been used for the management of patients with refractory chylothorax not responding to conservative management. OBJECTIVES: To assess the efficacy and safety of octreotide in the treatment of chylothorax in neonates. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE and EMBASE (to March 7, 2010). We assessed the reference lists of identified trials and abstracts from the annual meetings of the Pediatric Academic Societies published in Pediatric Research (2002 to 2009) without language restrictions. SELECTION CRITERIA: We planned to include randomised or quasi-randomised controlled trials of octreotide in the treatment of congenital or acquired chylothorax in term or preterm neonates, with any dose, duration or route of administration. DATA COLLECTION AND ANALYSIS: Data on primary (amount of fluid drainage, respiratory support, mortality) and secondary outcomes (side effects) were planned to be collected and analysed using mean difference, relative risk and risk difference with 95% confidence intervals. MAIN RESULTS: No randomised controlled trials were identified. Nineteen case reports of 20 neonates with chylothorax in whom octreotide was used either subcutaneously or intravenously were identified. Fourteen case reports described successful use (resolution of chylothorax), four reported failure (no resolution) and one reported equivocal results following use of octreotide. The timing of initiation, dose, duration and frequency of doses varied markedly. Gastrointestinal intolerance and clinical presentations suggestive of necrotizing enterocolitis and transient hypothyroidism were reported as side effects. AUTHORS' CONCLUSIONS: No practice recommendation can be made based on the evidence identified in this review. A prospective registry of chylothorax patients and a subsequent multicenter randomised controlled trial are needed to assess the safety and efficacy of octreotide in the treatment of chylothorax in neonates.
Language:
eng
MeSH:
Chylothorax/*drug therapy; Humans; Infant, Newborn; Octreotide/*therapeutic use
ISSN:
1469-493X (Electronic); 1361-6137 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorDas, Animitraen_GB
dc.contributor.authorShah, Prakeshkumar Sen_GB
dc.date.accessioned2012-02-01T10:52:39Z-
dc.date.available2012-02-01T10:52:39Z-
dc.date.issued2012-02-01T10:52:39Z-
dc.identifier.citationCochrane Database Syst Rev. 2010 Sep 8;(9):CD006388.en_GB
dc.identifier.issn1469-493X (Electronic)en_GB
dc.identifier.issn1361-6137 (Linking)en_GB
dc.identifier.pmid20824848en_GB
dc.identifier.doi10.1002/14651858.CD006388.pub2en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207961-
dc.description.abstractBACKGROUND: Routine care for chylothorax in neonate includes either conservative or surgical approaches. Octreotide, a somatostatin analogue, has been used for the management of patients with refractory chylothorax not responding to conservative management. OBJECTIVES: To assess the efficacy and safety of octreotide in the treatment of chylothorax in neonates. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE and EMBASE (to March 7, 2010). We assessed the reference lists of identified trials and abstracts from the annual meetings of the Pediatric Academic Societies published in Pediatric Research (2002 to 2009) without language restrictions. SELECTION CRITERIA: We planned to include randomised or quasi-randomised controlled trials of octreotide in the treatment of congenital or acquired chylothorax in term or preterm neonates, with any dose, duration or route of administration. DATA COLLECTION AND ANALYSIS: Data on primary (amount of fluid drainage, respiratory support, mortality) and secondary outcomes (side effects) were planned to be collected and analysed using mean difference, relative risk and risk difference with 95% confidence intervals. MAIN RESULTS: No randomised controlled trials were identified. Nineteen case reports of 20 neonates with chylothorax in whom octreotide was used either subcutaneously or intravenously were identified. Fourteen case reports described successful use (resolution of chylothorax), four reported failure (no resolution) and one reported equivocal results following use of octreotide. The timing of initiation, dose, duration and frequency of doses varied markedly. Gastrointestinal intolerance and clinical presentations suggestive of necrotizing enterocolitis and transient hypothyroidism were reported as side effects. AUTHORS' CONCLUSIONS: No practice recommendation can be made based on the evidence identified in this review. A prospective registry of chylothorax patients and a subsequent multicenter randomised controlled trial are needed to assess the safety and efficacy of octreotide in the treatment of chylothorax in neonates.en_GB
dc.language.isoengen_GB
dc.subject.meshChylothorax/*drug therapyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInfant, Newbornen_GB
dc.subject.meshOctreotide/*therapeutic useen_GB
dc.titleOctreotide for the treatment of chylothorax in neonates.en_GB
dc.contributor.departmentDepartment of Pediatrics, Waterford Regional Hospital, Dunmore Road, Waterford,, Ireland.en_GB
dc.identifier.journalCochrane database of systematic reviews (Online)en_GB
dc.description.provinceMunster-

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