Abstract | AIM: To evaluate the efficacy and safety of using recombinant human DNase ( rhDNase) in diminishing persistent atelectasis unresponsive to conventional treatment and mucus plugging in newborns with insufficient ability to clear thick and purulent airway secretions. METHODS: Twelve newborns (10 preterms), who did not respond to conventional methods, received rhDNase nebulized therapy at a dose of 1.25 mg over a 15-minute period, twice a day (2 hours between the doses) for up to 3 days. The application of the drug was continued for up to 3 days or until the improvement of atelectasis. After a-three-day therapy, if atelectasis did not improve, a single dose (1.25 mg) of the same drug in liquid form was administered endotracheally. Clinical (respiration rate, requirement for oxygen concentration) and radiological response (chest x-ray scoring), duration of the treatment, recurrence of atelectasis and requirement for additional therapy were evaluated. RESULTS: Ten out of 12 patients showed rapid clinical and radiological improvement after nebulized treatment. Two patients who did not respond to the three-day regimen received a single dose of the drug endotracheally and both recovered completely. Six patients did not require completion of three day regimen for radiological recovery. Chest x-ray scores and respiratory parameters showed significant improvement after the treatment. The respective median (range) values before and after treatment were 4 (1-5) and 0 (0-4) points for chest x-ray scores, 66 (60-78) and 49 (44-64) breaths/min for respiratory rates, and 45% (35-64) and 30% (21-40) for oxygen requirement. Comparison of pCO(2) before (median, 56 mm Hg; range, 46-64) and after treatment (median, 41 mm Hg; range 38-58) in 7 patients showed significant improvement. CONCLUSION: In a large series of newborns to receive rhDNase and we demonstrated the usefulness of rhDNase as a mucolytic agent in treating newborns with persistent atelectasis who do not respond to other treatments.
|
Authors | Omer Erdeve, Nurdan Uras, Begum Atasay, Saadet Arsan |
Journal | Croatian medical journal
(Croat Med J)
Vol. 48
Issue 2
Pg. 234-9
(Apr 2007)
ISSN: 1332-8166 [Electronic] Croatia |
PMID | 17436388
(Publication Type: Case Reports, Journal Article)
|
Chemical References |
- DNASE1 protein, human
- Deoxyribonuclease I
|
Topics |
- Administration, Inhalation
- Deoxyribonuclease I
(administration & dosage)
- Dose-Response Relationship, Drug
- Female
- Humans
- Infant, Newborn
- Intubation, Intratracheal
- Male
- Nebulizers and Vaporizers
- Pulmonary Atelectasis
(diagnosis, drug therapy)
- Treatment Outcome
|