Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Drug treatment of chylothorax. Physiological aspects

Authors: N.Yu. Kas yanova, V.S. Arakelyan, A.A. Malinin, N.A. Gidaspov, L.A. Bockeria

Company:
A.N. Bakoulev Scientific Center for Cardiovascular Surgery, Ministry of Health of the Russia, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

UDC: 616.12-089.168-06-003-24.08-036.8

Link: Clinical Physiology of Blood Circulaiton. 2016; 13 (2): 85-92

Quote as: Kas'yanova N.Yu., Arakelyan V.S., Malinin A.A., Gidaspov N.A., Bockeria L.A. Drug treatment of chylothorax. Physiological aspects. Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2016; 13 (2): 85-92 (in Russ.)

Received / Accepted:  01.04.2016/07.04.2016

Full text:  

Abstract

This review is the incidence of the main reasons for chylothorax and its treatment. We discuss the physiological aspects of the clinical efficacy of the endogenous hormone somatostatin and its synthetic analogue octreotide with chylothorax. When using the above-mentioned drugs is important to pay special attention to the unit, which was determined by the dose of the drug. Considering the literature data, the efficacy and safety of octreotide in the treatment of chylothorax observed in adults and in children with a duration of treatment for a month, the use of octreotide at doses up to 288 mcg/kg/day did not lead to increased toxicity. Unfortunately, there are no clear data on octreotide dosing regimens depending on the age, weight and quantity of drainable chyle. All this causes uncertainty among clinicians and requires further study.

References

1. Соколовская М.А., Манеров Ф.К., Мальцева Е.В., Черпакова Е.Я. Хилоторакс у новорожденных де­тей. Педиатрия. 2015; 1: 83—5.

2. Babu A., Rattan A, Ranjan R, Kumar S., Gupta A. Chylothorax due to blunt Torso Trauma: A Rare Etiology. J. Trauma Treat. 2015; 4: 243.

3. Yao Mun Choo, Chin Theam Lim. Treatment of con­genital chylothorax with octreotide in a hydropic preterm infant. J Paediatr Child Health. 2013; 33 (2): 116-9.

4. McGrath E.E., Blades Z., Anderson P.B. Chylothorax: Aetiology, diagnosis and therapeutic options. Respiratory Medicine. 2010; 104 (1): 1—8.

5. Бокерия Л.А., Абалмасов K.E, Морозов K.M., Пузен- ко Д.В., Белов С.В. Повреждение грудного лимфати­ческого протока. Анналы хирургии. 2007; 2: 17—21.

6. Roehr С.С., Jung A, Proquitte Н., Blankenstein О., Hammer Н., Lakhoo К. et al. Somatostatin or octreotide as treatment options for chylothorax in young children: a systematic review, lnt. Care Med. 2006; 32: 650-7.

7. Beghetti M., La Scala G., Belli D. Etiology and man­agement of pediatric chylothorax. J. Pediatr. 2000; 1369 (5): 653-65.

8. Rennie J.M., Roberton N.R.C. Textbook of Neonatology. 3rd edition. Churchill Livingstone; 1999.

9. Chih-Min Tsai, Chia-Hao Kang, Shin-Yi Lee, Ya-Chuan Ting, Chin-Ling Li, Chin-Ching Ku et al. Congenital Chylothorax Complicated with Hemotho­rax after OK-432 Pleurodesis. J. Pediatr. Resp. Dis. 2014; 10: 5-7.

10. Tutor J.D. Chylothorax in Infants and Children. Pediatrics. 2014; 133 (4).

11. Kalay Salih, Oztekin Osman, Tezel Gonul, Demir Burak Emre, Akcakus Mustafa, Oygur Nihal. Octreotide treatment in a neonate with non-chylous pleural effusion. Afr. J. Paediatr. Surg. 2013; 10 (4): 374.


12. Shih Y.T., Su P.H., Chen J.Y., Lee I.C., Hu J.M., Chang H.P. Common Etiologies of Neonatal Pleural Effusion. Pediatr. Neonatol. 2011; 52 (5): 251—5.

13. Yoon Jin Ahn, You Hoon Jeon, Sung Shin Kim, Jae Ock Park, Chang Hwi Kim. Treatment of congenital chylothorax in a premature infant using octreotide. J. Korean Soc. Neonatol. 2006; 13: 261—6.

14. Rogers L.S., Glatz A.C., Ravishankar C., Spray TL., Nicolson S.C., Rychik J. et al. 18 years of the Fontan operation at a single institution: results from 771 con­secutive patients. J. Am. Coll. Cardiol. 2012; 60 (11): 1018-25.

15. Еорячев В.В., Шорохов С.Е., Хохлунов С.М., Авра­менко А.А, Суслина Е.А., Козева И.Е и др. Два случая успешного консервативного лечения хило­торакса октреотидом после операции наложения верхнего двунаправленного кавопульмонального анастомоза. Детские болезни сердца и сосудов. 2008; 4: 71-2.

16. Спринджук М.В. Плевральная транссудация — ос­ложнение после операций Еленна и Фонтена. Ме­дицинская панорама. 2008; 4: 5.

17. Yasin Sahin, Derya Aydin. Congenital Chylothorax treated with octreotide. Indian J. Pediatr. 2005; 72: 885-8.

18. Перельман М.И., Юсупов И.А., Седова TH. Хи­рургия грудного протока. М.; 1984.

19. Okan Yildiz, Erkut Ozturk, Husnu Firat Altin, Pelin Ayyildiz, Taner Kasar, Ahmet Irdem et al. Chylothorax following pediatric cardiac surgery. Turk, Gogus. Kalp. Вата. 2015; 23 (3): 434-40.

20. Спиридонов A.A., Аракелян В.С., Малинин А.А. Тактика лечения экстра- и интраторакальных по­вреждений грудного протока и его притоков в сер­дечно-сосудистой хирургии. Анналы хирургии. 2003; 2: 39-46.

21. Talwar S., Agarwala S., Mittal C.M., Choudhary S.K., Airan B. Pleural effusions in children undergoing car­diac surgery. Ann. Pediatr. Cardiol. 2010; 3: 58—64.

22. Ergin Kocyildirim, Yavuz Yorukoglu, Enver Ekici, Coskun Ikizler. High-dose octreotide treatment for per­sistent pleural effusion after the extracardiac Fontan procedure. Anadolu KardiyolDerg. 2008; 8 (1): 75—6.

23. Подзолков В.П., Заец С.Б., Чиаурели М.Р. и др. Еи- дрохилоторакс после операции Фонтена. Грудная и сердечно-сосудистая хирургия. 1998; 3: 16—9.

24. Mery С.М., Moffett B.S., Khan M.S., Zhang W, Guzm6n-Pruneda F.A., Fraser C.D. Jr et al. Incidence and treatment of chylothorax after cardiac surgery in children: analysis of a large multi-institution database. J. Thorne. Cardiovasc. Surg. 2014; 147 (2): 678—86.

25. Reza Saeidi, Shadi Nourizadeh. Octreotide for the Management of Chylothorax in Newborns, Case Report. Iranian Journal of Neonatology. 2014; 5 (4): 37-9.

26. Sharkey A.J., Rao J.N. The Successful use of octreotide in the treatment of traumatic chylothorax. Tex. Heart Inst. J. 2012; 39 (3): 428-30.

27. Tatar T, Kilic D., Ozkan M., Hatipoglu A., Aslamaci S. Management of chylothorax with octreotide after con­genital heart surgery. Thorac. Cardiovasc. Surg. 2011; 59 (5): 298-301.

28. Caverly L., Rausch C.M., da Cruz E., Kaufman J. Octreotide treatment of chylothorax in pediatric patients following cardiothoracic surgery. Congenit. Heart Dis. 2010; 5 (6): 573-8.

29. Das A, Shah PS. Octreotide for the treatment of chy­lothorax in neonates. Cochrane Database of Systematic Reviews. 2010; 9.

30. Parames Е, Freitas I., Fragata J., Trigo C., Pinto M.F. Octreotide-additional conservative therapy for postop­erative chylothorax in congenital heart disease. Rev. Port. Cardiol. 2009; 28 (7-8): 799-80.

31. Yaffe S.J., Aranda J.V. High-dose octreotide treatment of traumatic chylothorax. Neonatal and pediatric phar­macology therapeutic principles in practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health; 2010.

32. Wright S.B., Mainwaring R.D. Octreotide for manage­ment of chylothorax following bidirectional Glenn in a three-month-old infant. I Card. Surg. 2009; 24 (2): 216-8.

33. Chan S.Y., Lau W„ Wong W.H., Cheng L.C., Chau A.K., Cheung Y.F. Chylothorax in children after congenital heart surgery. Ann. Thorac. Surg. 2006; 82 (5): 1650-6.

34. Helin R.D., Angeles S.T., Bhat R. Octreotide therapy for chylothorax in infants and children: A brief review. Pediatr. Crit. Care Med. 2006; 7 (6): 576—9.

35. Kaneko M., Hiramatsu T., Nishimura Y, Iwahashi M., Komori S., Shibata M. et al. Effects of octreotide acetate on intractable chylothorax after surgery for con­genital heart diseases. Kyobu Geka. 2006; 59 (7): 561—4.

36. Rosti L., De Battisti F., Butera G., Cirri S., Chessa M., Delogu A. et al. Octreotide in the management of post­operative chylothorax. Pediatr. Cardiol. 2005; 26 (4): 440-3.

37. Al-Zubairy S.A., Al-Jazairi A.S. Octreotide as a thera­peutic option for management of chylothorax. Ann. Pharmacother. 2003; 37 (5): 679—82.

38. Аксарин A.A., Тер-Ованесов М.Д. Хилоторакс - редкое осложнение в хирургии рака легкого. Хи­рург. 2013; 6: 16—21.

39. Schild Н., Strassburg С.Р., Welz A., Kalff J. Treatment options in chylothorax. Dtsch ArztebI Int. 2013; 110 (48): 819-26.

40. Ким А.И., Мовсесян P.P., Абдувохидов Б.У., Болта- баев И.И., Рогова ТВ., Ерохина О.В. и др. Случай успешного консервативного лечения хилоторакса у младенца после радикальной коррекции общего открытого атриовентрикулярного канала. Детские болезни сердца и сосудов. 2011; 3: 64—6.

41. Белов Ю.В., Миланов Н.О., Степаненко А.Б., Еаса- нов А.Ф. Хилоторакс в торакальной хирургии. Хи­рургия. 2012; 10: 61—4.

42. Kessel Т, Makhoul Т, Sujov Р. Congenital Hypothyro­idism and nonimmune hydrops fetalis. Associatide pedi­atrics. 1999; 103: 9—11.

43. Jigang Yang, Ion Codreanu, Hongming Zhuan. Minimal Lymphatic Leakage in an Infant with Chylothorax Detected by Lymphoscintigraphy SPECT/CT. Pediatrics. 2014; 134 (2).

44. Beer H.G., Mol M.J., Janssen J.P. Chylothorax. Neth. J. Med. 2000; 56 (1): 25-31.

45. Lien Van De Voorde, Ben Vanneste, Jacques Borger, Esther G.C. Troost, Philo Werner. Rapid Decline of Follicular Lymphoma-Associated Chylothorax after Low Dose Radiotherapy to Retroperitoneal Lymphoma Localization. Case Reports in Hematology. 2014: Article ID 684689.

46. Bikash Bhattarai, Frances Schmidt, Ashok Devkota, Geraldine Policard, Saveena Manhas, Vikram Oke et al. A case of chylothorax in a patient with sarcoidosis: a rare and potentially fatal complication. Journal of Community Hospital Internal Medicine Perspectives. 2015; 5: 1-4.

47. Щербакова L.H., Иванов A.C., Лебедева A.B., Мо­розова С.А. Парентеральное питание в терапевти­
ческом лечении хилоторакса после хирургичес­кой коррекции коарктации аорты. Анестезиология и реаниматология. 2008; 5: 40—2.

48. Octreotide acetate. Drug facts and comparisons. Efacts [online] 2004. Wolters Kluwer Health; 2004.

49. Boffa D.J., Sandsb M.J., Ricea TW. et.al. A critical evaluation of a percutaneous diagnostic and treatment strategy for chylothorax after thoracic surgery. Eur. J. Cardiothorac. Surg. 2008; 33: 435—9.

50. Bello S.O., Rahamim J. High-dose intravenous octreotide is safe and may be superior to surgery in managing severe postesophagectomy chylothorax in high-risk patients. Ann. Thorac. Surgeiy. 2015; 100 (1): 297-9.

About Authors

Kas'yanova Natal'ya Yur'evna, Postgraduate;
Arakelyan Valeriy Sergeevich, MD, PhD, DSc, Professor, Chief of Department of Pathology of Arterial Surgery;
Malinin Aleksandr Aleksandrovich, MD, PhD, DSc, Leading Research Associate;
Gidaspov Nikita Andreevich, MD, PhD, Research Associate;
Bookeria Leo Antonovich, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences and Russian Academy of Medical Sciences, Director

 If you found mistakes, select text and press Alt+A