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Recombinant human deoxyribonuclease shortens ventilation time in young, mechanically ventilated children

Joachim Riethmueller1, Thomas Borth-Bruhns, Matthias Kumpf

  • 1Department of Pediatrics, University Children's Hospital, Tübingen, Germany. joachim.riethmueller@med.uni-tuebingen.de

Pediatric Pulmonology
|November 3, 2005
PubMed

Insights

Dornase alfa, a recombinant human deoxyribonuclease I, may reduce ventilation duration and PICU stay in ventilated infants. This study found dornase alfa beneficial and safe for fluid-restricted children requiring mechanical ventilation.

Area of Science:

  • Biochemistry
  • Pediatric Critical Care
  • Pharmacology

Background:

  • Recombinant human deoxyribonuclease I (dornase alfa) is an established inhaled mucoactive agent for cystic fibrosis.
  • The potential use of dornase alfa in ventilated, fluid-restricted pediatric patients remains under investigation.

Purpose of the Study:

  • To evaluate the efficacy and safety of dornase alfa in reducing reintubation rates, ventilation duration, pediatric intensive care unit (PICU) stay, and ventilation complications in ventilated, fluid-restricted infants.
  • To explore the potential benefits of dornase alfa in fluid-restricted children, particularly those expected to require prolonged mechanical ventilation after cardiac surgery.

Main Methods:

  • A randomized, placebo-controlled, double-blind clinical study involving 100 infants.
  • Administration of dornase alfa versus placebo in ventilated, fluid-restricted children.
  • Assessment of reintubation rates, ventilation duration, PICU stay, ventilation complications, and costs.

Main Results:

  • Reintubation rates were similar between the dornase alfa and placebo groups (7% vs. 9%).
  • The dornase alfa group showed a lower incidence of atelectasis (6 vs. 17), shorter median ventilation time (2.2 vs. 3.4 days), and shorter median PICU stay (7 vs. 8 days).
  • Mean costs were reduced in the dornase alfa group (4,830 vs. 6,320), and no adverse effects were observed.

Conclusions:

  • Dornase alfa demonstrated beneficial effects and a favorable safety profile in ventilated, fluid-restricted infants.
  • The findings suggest dornase alfa may be valuable from the first day of mechanical ventilation, especially for children anticipated to require >3 days of ventilation post-cardiac surgery.

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