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DNase treatment for atelectasis in infants with severe respiratory syncytial virus bronchiolitis

P J Merkus1, M de Hoog, R van Gent

  • 1Dept of Paediatrics, Sophia Children's Hospital, Erasmus Medical Centre Rotterdam, The Netherlands.

The European Respiratory Journal
|November 22, 2001
PubMed

Insights

Recombinant human deoxyribonuclease (rhDNase) may effectively treat severe respiratory syncytial virus (RSV) bronchiolitis by liquefying mucus and reducing lung atelectasis in infants. This treatment offers a potential therapeutic option for complicated cases.

Area of Science:

  • Pediatrics
  • Pulmonology
  • Virology

Background:

  • Respiratory syncytial virus (RSV) bronchiolitis causes respiratory insufficiency due to thickened mucus and cellular debris.
  • Airway secretions in RSV bronchiolitis are viscoelastic due to polymerized deoxyribonucleic acid (DNA).
  • Recombinant human deoxyribonuclease (rhDNase) is known to improve mucus viscosity in cystic fibrosis.

Observation:

  • Two infants with RSV bronchiolitis and severe atelectasis, facing imminent mechanical ventilation, were treated.
  • Three mechanically ventilated infants (including neonates and one with bronchopulmonary dysplasia) with RSV bronchiolitis and pneumonia also received treatment.
  • The treatment involved nebulized rhDNase at 2.5 mg twice daily.

Findings:

  • Nebulized rhDNase led to rapid improvements in clinical and radiological parameters.
  • Mechanical ventilation was avoided in two infants.
  • Three ventilated infants showed clinical recovery after the first rhDNase dose.

Implications:

  • Nebulized rhDNase may be a viable treatment for atelectasis in severe or complicated RSV bronchiolitis.
  • This approach could potentially prevent the need for mechanical ventilation in infants.
  • Further therapeutic trials of rhDNase are warranted for infantile RSV bronchiolitis.

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