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The use of dornase alpha for post-operative pulmonary atelectasis after congenital heart surgery
Erkut Ozturk1, Ibrahim C Tanidir1, Sertac Haydin2
11Department of Pediatric Cardiology,Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital,Istanbul,Turkey.
Insights
Dornase alpha effectively managed post-surgery pulmonary atelectasis in children. This mucolytic agent improved lung function and reduced respiratory rates after congenital heart operations.
Area of Science:
- Pediatric Critical Care Medicine
- Cardiothoracic Surgery
- Pulmonology
Background:
- Pulmonary atelectasis is a common complication following congenital heart surgery in children.
- Conventional treatments, including chest physiotherapy, may be insufficient for resistant cases.
Purpose of the Study:
- To evaluate the efficacy of dornase alpha as a mucolytic agent in pediatric patients with post-operative pulmonary atelectasis after congenital heart surgery.
- To compare outcomes between patients treated with dornase alpha and those receiving standard care.
Main Methods:
- Retrospective case-control study conducted in a pediatric cardiac intensive care unit.
- 41 patients with post-operative pulmonary atelectasis resistant to conventional therapy were analyzed.
- 26 patients received dornase alpha, while 15 served as a control group receiving conventional treatment and physiotherapy.
Main Results:
- Dornase alpha treatment significantly reduced the median atelectasis score (3.4 to 0.8, p=0.001).
- Oxygenation (pO2) improved significantly (69 to 89 mmHg, p=0.04) in the dornase alpha group.
- Heart rate and respiratory rate per minute decreased significantly (p < 0.05) with dornase alpha, with no significant changes in the control group.
Conclusions:
- Dornase alpha demonstrates efficacy in managing pulmonary atelectasis following congenital heart surgery in pediatric patients.
- The mucolytic agent offers a potential therapeutic option for improving respiratory outcomes in this vulnerable population.
Objective:
To investigate the efficacy of dornase alpha, a mucolytic agent, in children who developed pulmonary atelectasis after congenital heart surgery.
Design:
Retrospective case-control study.
Setting:
Paediatric cardiac intensive care unit at a tertiary care hospital.
Patients:
Between July, 2011 and July, 2012, 41 patients who underwent congenital cardiac operations and developed post-operative pulmonary atelectasis that was resistant to conventional treatment and chest physiotherapy.
Interventions:
In all, 26 patients received dornase alpha treatment. As a control group, 15 patients were treated with conventional medications and chest physiotherapy.
Main Results:
The median age of patients was 25.5 (3-480) days in the study group and 50.0 (3-480) days in the control group. A total of 15 (57.6%) patients in the study group and 8 (53.3%) patients in the control group were male. The median weight was 4.2 (2.9-14.2) kg and 4.0 (3.5-13.6) kg in the study and control group, respectively. In the study group, pulmonary atelectasis was diagnosed at a median period of 5 (2-18) days after operations, whereas in the control group atelectasis was diagnosed at a median period of post-operative 6 (3-19) days. In the study group, the median atelectasis score decreased from 3.4 (1-6) to 0.8 (0-3) (p = 0.001). The median pO2 level increased from 69 (17-142) mmHg to 89 (30-168) mmHg (p = 0.04). In addition, heart rate and respiratory rate per minute were significantly decreased (p < 0.05). There were no significant changes in these parameters in the control group.
Conclusions:
The use of dornase alpha can be effective for the management of pulmonary atelectasis that develops following congenital heart surgery.
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