%0 Journal Article
%T DNase and atelectasis in non-cystic fibrosis pediatric patients
%A Tom Hendriks
%A Matthijs de Hoog
%A Maarten H Lequin
%A Annick S Devos
%A Peter JFM Merkus
%J Critical Care
%D 2005
%I BioMed Central
%R 10.1186/cc3544
%X All non-cystic fibrosis pediatric patients who received nebulised or endotracheally instilled DNase for atelectasis between 1998 and 2002, with and without mechanical ventilation, were analysed in a retrospective descriptive study. The endpoints were the blood pCO2, the heart rate, the respiratory rate, the FiO2 and the chest X-ray scores before and after treatment.In 25 of 30 patients (median [range] age, 1.6 [0.1¨C11] years) who met inclusion criteria, paired data of at least three endpoints were available. All clinical parameters improved significantly within 2 hours (P < 0.01), except for the heart rate (P = 0.06). Chest X-ray scores improved significantly within 24 hours after DNase treatment (P < 0.001). Individual improvement was observed in 17 patients and no clinical change was observed in five patients. Temporary deterioration (n = 3) was associated with increased airway obstruction and desaturations. No other complications were observed.After treatment with DNase for atelectasis of presumably infectious origin in non-cystic fibrosis pediatric patients, rapid clinical improvement was observed within 2 hours and radiologic improvement was documented within 24 hours in the large majority of children, and increased airway obstruction and ventilation¨Cperfusion mismatch occurred in three children, possibly due to rapid mobilisation of mucus. DNase may be an effective treatment for infectious atelectasis in non-cystic fibrosis pediatric patients.Atelectasis is a problem in many children with respiratory infections or who require ventilation. At least 8% of children on mechanical ventilation develop pulmonary atelectasis, with a concomitant increase in the morbidity and the length of stay [1]. There is no 'golden standard' for treatment of atelectasis in children. Efficacy of treatment modalities such as inhaled bronchodilators, steroids, physiotherapy and nebulised sodium chloride (NaCl 0.9%) has not been demonstrated [2].Atelectasis is commonly caused by sputum
%U http://ccforum.com/content/9/4/R351