Safety and Effectiveness of Somatostatin and Analogues on Chest Tube Output After Coronary Artery Bypass Grafting: A Scoping Review.

Abstract

Abstract: Somatostatin and analogues may reduce chest tube (CT) output in chylothorax caused by postcoronary artery bypass grafting (CABG). However, data are limited to case reports and series. This scoping review aimed to describe the efficacy and safety of somatostatin/analogue use in post-CABG chylothorax. We retrieved from PubMed, Embase, and OVID all studies and case reports describing somatostatin/analogue use in adult patients post-CABG for resolution of chylothorax. The primary outcome was time from somatostatin/analogue initiation to daily CT output <100 mL/d. CT duration, need to repeat invasive intervention, and safety events associated with somatostatin/analogues were also analyzed. Somatostatin/analogues were associated with reductions in CT output, but one-third of patients still required pleurodesis or surgical intervention. No safety events were identified. Patients with lower daily CT outputs at the time of somatostatin/analogue initiation were more likely to avoid repeat intervention than those with higher outputs. In conclusion, somatostatin/analogues seem safe and possibly effective in management of post-CABG chylothorax. Future studies should investigate which patients are most likely to benefit from this therapy.