High Dose Octreotide for the Treatment of Chylothorax in Three Neonates

Makoto Saito, Tomohiro Kamoda, Daigo Kajikawa, Yayoi Miyazono, Yu Kanai, Satoshi Fujiyama, Ryoko Suzuki, Miho Takahashi-Igari, Yasuhisa Urita and Ryo Sumazaki

Chylothorax is an abnormal condition of lymphatic fluid collection in the pleural space, and the somatostatin analog octreotide is thought to have a beneficial effect on chylothorax. However, the octreotide dosage and administration route for chylothorax have been inconsistent to date. We report three neonatal cases of persistent chylothorax successfully treated with high-dose octreotide infusion therapy (20 μg/kg/h). Case 1 was congenital chylothorax, Case 2 was secondary chylothorax after an operation for congenital diaphragmatic hernia, and Case 3 was chylothorax after a cardiac operation. In all cases, the chylothorax was not decreased by a low-dose octreotide infusion, but after a high-dose octreotide infusion, the chylothorax decreased and eventually vanished, with no side effects.

Conclusion: We suggest that the dose of octreotide in neonatal chylothorax can be safely increased to a maximum of 20 µg/kg/h.