Ann Thorac Surg 2005;80:1982
© 2005 The Society of Thoracic Surgeons
Correspondence
Reply
Mohamed A. Hamdan, MD
Tawam Hospital, PO Box 15258, Al Ain, Abu Dhabi, United Arab Emirates
(Email: mhamdan{at}tawam-hosp.gov.ae).
To the Editor:
In the report by Roehr and colleagues [1], initiation of parenteral octreotide (OCT) led to the resolution of loculated chylothorax and resumption of full-fat human milk (FFHM). Similar to our patient [2], their patient had chylothorax develop despite being maintained on total parenteral nutrition then low-fat formula. It was not until OCT was used that FFHM could be started. It should be noted though, that after OCT initiation, Roehr and colleagues [1] used FFHM much later than when we used it in our patient. In other words, in our patient, low-fat human milk was used as an adjunct to OCT treatment to replace other low-fat formulas. However, in the report by Roehr and colleagues [1], FFHM was introduced only after OCT treatment had resulted in near cessation of the chylothorax.
The two reports should stimulate further research into the role of human milk in patients with chylothorax, as it can be an important adjunct to whatever treatment modality is chosen. It has been shown that human milk contains a high concentration of somatostatin [3]. Once absorbed, ingested somatostatin may exert an inhibitory effect on the intestinal and pancreatic secretions [3]. Whether this has any clinical benefit in the reduction of chylothorax is currently unknown and is subject to further research.
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References
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- Roehr CC, Jung A, Curcin OA, Proquitte H, Hammer H, Wauer RR. Loculated neonatal chylothorax treated with octreotidecomplete recovery while on unrestricted full fat breast milk (letter). Ann Thorac Surg 2005;80:1981-1982.[Free Full Text]
- Hamdan MA, Gaeta ML. Octreotide and low-fat breast milk in postoperative chylothorax Ann Thorac Surg 2004;77:2215-2217.[Abstract/Free Full Text]
- Goldstein A, Armony-Sivan R, Rozin A, Weller A. Somatostatin levels during infancy, pregnancy, and lactationa review. Peptides 1995;16:1321-1326.[Medline]
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