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DNase and atelectasis in non-cystic fibrosis pediatric patients

Tom Hendriks1, Matthijs de Hoog, Maarten H Lequin

  • 1Catharina Hospital, Eindhoven, The Netherlands.

Critical Care (London, England)
|September 3, 2005
PubMed

Insights

DNase treatment rapidly improved clinical symptoms within 2 hours and radiologic findings within 24 hours in pediatric patients with atelectasis. This suggests DNase may be an effective treatment for infectious atelectasis in children without cystic fibrosis.

Area of Science:

  • Pulmonology
  • Pediatric Medicine
  • Pharmacology

Background:

  • Atelectasis lacks evidence-based treatments.
  • Persistent atelectasis in children often requires novel therapeutic approaches.
  • Current treatments like bronchodilators and physiotherapy are not always effective.

Purpose of the Study:

  • To evaluate the clinical and radiologic effects of DNase in pediatric patients with persistent atelectasis.
  • To assess DNase efficacy in non-cystic fibrosis children unresponsive to standard therapies.
  • To identify potential complications associated with DNase treatment for atelectasis.

Main Methods:

  • Retrospective descriptive study of non-cystic fibrosis pediatric patients treated with DNase (nebulized or endotracheal).
  • Inclusion criteria: persistent atelectasis unresponsive to bronchodilators and physiotherapy.
  • Endpoints: blood pCO2, heart rate, respiratory rate, FiO2, and chest X-ray scores before and after treatment.

Main Results:

  • Significant clinical improvement in most parameters within 2 hours (p < 0.01).
  • Significant improvement in chest X-ray scores within 24 hours (p < 0.001).
  • Temporary airway obstruction and desaturations occurred in 3 patients, possibly due to mucus mobilization.

Conclusions:

  • DNase demonstrated rapid clinical and radiologic improvement in pediatric patients with infectious atelectasis.
  • DNase may be a viable treatment option for atelectasis in non-cystic fibrosis pediatric patients.
  • Potential for mucus mobilization complications necessitates careful monitoring.
Abstract

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