Tratamiento del quilotórax posquirúrgico con octreótido
- E. Aleo Luján
- M.aM. Urán Moreno
- K.B. Brandstrup Azuero
- J. López-Herce Cid
- J.L. Zunzunegui Martínez
ISSN: 1695-4033, 1696-4608
Any de publicació: 2003
Volum: 58
Número: 4
Pàgines: 390-392
Tipus: Article
Altres publicacions en: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )
Resum
Chylothorax is an infrequent complication of cardiac surgery in children. Most patients respond to a low-fat diet or to parenteral nutrition, but pleuroperitoneal drainage or thoracic duct ligature is sometimes required. We present the case of a 3-year-old girl with Down syndrome and complexatrioventricular canal defect who presented chylothorax 22 days after the Glenn procedure with bidirectional pulmonarycava fistula. Low-fat diet and parenteral nutrition produced no improvement and the patient was treated with octreotide 1-2 mcg/kg/min in intravenous continuous perfusion, which produced remission of chylothorax. Subsequently, 20 mcg/kg/day of octreotide was subcutaneously administered in three doses, allowing progressive dietary normalization, without recurrence of chylothorax or adverse effects. In conclusion, octreotide is well tolerated and produces few adverse effects. It could be used as a therapeutic alternative in chylothorax refractory to conservative treatment.