Richard Mainwaring

Publication Details

  • Octreotide for Management of Chylothorax following Bidirectional Glenn in a Three-Month-Old Infant JOURNAL OF CARDIAC SURGERY Wright, S. B., Mainwaring, R. D. 2009; 24 (2): 216-218

    Abstract:

    Chylothorax developing after open heart surgery for congenital heart defects can be a challenging problem. Established therapies are not always efficacious. This report summarizes our experience using octreotide as an adjunct in the management of an intractable chylous effusion.The patient described underwent a bilateral bidirectional cavopulmonary anastomosis at 3 months of age. Postoperatively, the patient demonstrated significant quantities of milky fluid drainage from the right pleural chest tube. Initial management included diuretics, afterload reduction, and a non-fat diet. These maneuvers appeared to be effective. However, the patient experienced a recurrence of the effusion requiring re-admission to the hospital and re-insertion of a right pleural chest tube. Given the recalcitrant nature of the effusion, an infusion of octreotide was begun.An octreotide infusion was begun at 1 mcg/kg/hr and gradually increased to 3 mcg/kg/hr. Chest tube drainage diminished allowing chest tube removal 13 days later. The octreotide infusion was weaned off over the subsequent 10 days without any further effusion problems.Octreotide may be a useful adjunct in the management of intractable chylous effusions following congenital heart surgery.

    View details for DOI 10.1111/j.1540-8191.2008.00803.x

    View details for Web of Science ID 000263694600033

    View details for PubMedID 19267835

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