Nebulized rhDNase therapy in newborn infants with atelectasis

Abstract

Gonderilme tarihi: 05.11.2013 Kabul tarihi: 10.01.2014 Abstract Purpose:To see the efficacy in atelectasis and clinical effectiveness of rhDNase in newborns unresponsive to conventional therapy. Material and methods: Eight newborns (7 premature) with atelectasis in the lungs were evaluated retrospectively. All patients were given rhDNase 2.5 mg twice daily with nebulizer for up to 3 days after conventional therapies. Results:The birth weight and gestational age of the patients ranged respectively from 500 g to 3000 g and 25 weeks to 41 weeks. When atelectasis developed, six of eight patients were mechanically ventilated. Infants received a dosage of 2.5 mg rhDNase every 12 hours with nebulizer for 3 days. Six of 8 patients showed almost complete improvement after the rhDNase treatment. One patient who did not respond to the treatment had an underlying hypoxic ischemic encephalopathy and complicated pneumonia. This patient died during the follow up. The other patient gave partial response to treatment. Of 6 mechanically ventilated patients 3 patients extubated in 3 days, one patient extubated after 9 days and two patients could not be extubated. Atelectasis relapsed in 6 patients. After second 3-day course of treatment by a nebulizer, recovery was seen in 3 days. There was no side effect due to rhDNase treatment. Conclusion:We suggest that rhDNase may be administered as an alternative treatment to the newborn infants with atelectasis in their lung. Especially, if there was no underlying disease, and if they did not respond to conventional treatment for atelectasis. More studies should be done with larger study groups.