Propranolol As a Treatment Option for Chylous Effusions and Chylous Ascites in Fetuses and Neonates: A Systematic Review.

Q2 Medicine Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-10-01 Epub Date: 2024-10-14 DOI:10.5863/1551-6776-29.5.468
Brianna Courteau, Gabriella Zarlenga, Sandy P Narciso-Owen, Eric C Nemec Ii, Suzanne J Rose
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Abstract

Objective: Chylous effusion and chylous ascites are rare but serious conditions that affect both fetuses and neonates. Previous studies have documented chylous effusions or chylous ascites treatment with medications as an adjunct to respiratory support and dietary modifications, but no formal recommendations have been made. New literature suggests propranolol as an effective and safe treatment option, though no randomized clinical studies have been published to date. This review aims to assess the efficacy and safety of propranolol in the treatment of chylous effusion and chylous ascites in fetuses and newborns from case reports.

Methods: A comprehensive search of 10 databases and grey literature was completed. The inclusion criteria for articles were age at diagnosis less than 40 days old and case report/series. Articles were excluded if they were animal studies or not published in English.

Results: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 4 articles were ultimately included in the study for a total of 10 reported cases. Propranolol administered to mother and neonates was effective in 100% of cases. The most common oral dose for mothers was 20 mg, 4 times daily, titrated to 40 mg, 4 times daily. The maximum dosage varied for administration orally to neonates, with the median being 3 mg/kg/day. Side effects, including bradycardia and transient hypoglycemia, were seen in 20% of the cases and resolved with dose adjustment.

Conclusion: Propranolol is a relatively effective and safe treatment option for chylous effusion and chylous ascites that can be administered prenatally or to neonates.

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普萘洛尔作为胎儿和新生儿乳糜泻和乳糜腹水的治疗方案:系统综述。
目的:乳糜泻和乳糜腹水是一种罕见但严重的疾病,对胎儿和新生儿都有影响。以往的研究记录了用药物辅助呼吸支持和饮食调整治疗乳糜泻或乳糜腹水的方法,但尚未提出正式建议。新的文献表明,普萘洛尔是一种有效而安全的治疗选择,但迄今为止尚未发表任何随机临床研究。本综述旨在从病例报告中评估普萘洛尔治疗胎儿和新生儿乳糜泻和乳糜腹水的有效性和安全性:方法:对 10 个数据库和灰色文献进行了全面检索。文章的纳入标准为诊断时年龄小于 40 天和病例报告/系列。如果文章是动物研究或不是用英语发表的,则排除在外:根据系统综述和元分析首选报告项目(PRISMA)指南,研究最终纳入了 4 篇文章,共报告了 10 个病例。给母亲和新生儿服用普萘洛尔100%有效。母亲最常用的口服剂量为 20 毫克,每天 4 次,剂量递增至 40 毫克,每天 4 次。新生儿的最大口服剂量各不相同,中位数为 3 毫克/千克/天。20%的病例出现副作用,包括心动过缓和一过性低血糖,调整剂量后即可缓解:结论:普萘洛尔是治疗乳糜泻和乳糜腹水的一种相对有效和安全的方法,可在产前或新生儿期使用。
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来源期刊
Journal of Pediatric Pharmacology and Therapeutics
Journal of Pediatric Pharmacology and Therapeutics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
2.40
自引率
0.00%
发文量
90
期刊介绍: The Journal of Pediatric Pharmacology and Therapeutics is the official journal of the Pediatric Pharmacy Advocacy Group. JPPT is a peer-reviewed multi disciplinary journal that is devoted to promoting the safe and effective use of medications in infants and children. To this end, the journal publishes practical information for all practitioners who provide care to pediatric patients. Each issue includes review articles, original clinical investigations, case reports, editorials, and other information relevant to pediatric medication therapy. The Journal focuses all work on issues related to the practice of pediatric pharmacology and therapeutics. The scope of content includes pharmacotherapy, extemporaneous compounding, dosing, methods of medication administration, medication error prevention, and legislative issues. The Journal will contain original research, review articles, short subjects, case reports, clinical investigations, editorials, and news from such organizations as the Pediatric Pharmacy Advocacy Group, the FDA, the American Academy of Pediatrics, the American Society of Health-System Pharmacists, and so on.
期刊最新文献
Ketorolac Dose Ceiling Effect for Pediatric Headache in the Emergency Department. Management of Postural Orthostatic Tachycardia Syndrome in Pediatric Patients: A Clinical Review. Pediatric Lead Chelation Managed During Critical Medication Shortages: Case Report and Literature Review. Pharmacogenomics in Pediatric Oncology Research and Treatment. Propranolol As a Treatment Option for Chylous Effusions and Chylous Ascites in Fetuses and Neonates: A Systematic Review.
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