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The use of dornase alpha for post-operative pulmonary atelectasis after congenital heart surgery

Published online by Cambridge University Press:  06 August 2013

Erkut Ozturk ,
Ibrahim C. Tanidir ,
Sertac Haydin ,
Ismihan S. Onan ,
Ender Odemis  and
Ihsan Bakir
Erkut Ozturk
Affiliation:
Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
Ibrahim C. Tanidir*
Affiliation:
Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
Sertac Haydin
Affiliation:
Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
Ismihan S. Onan
Affiliation:
Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
Ender Odemis
Affiliation:
Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
Ihsan Bakir
Affiliation:
Department of Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
*
Correspondence to: I. C. Tanidir, MD, Department of Pediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istasyon Mah.Turgut Ozal Bulvari no. 11, Kucukcekmece 34303, Istanbul, Turkey. Tel: +90 212 692 20 00; Fax: +90 212 471 94 94; E-mail: cansaran@yahoo.com
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Abstract

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.

Keywords

Cardiac surgerydornase alphaintensive carepaediatricpost-operativepulmonary atelectasis
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 5 , October 2014 , pp. 807 - 812
Copyright
Copyright © Cambridge University Press 2013 

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References

1. Riethmueller, J, Kumpf, M, Borth-Bruhns, T, et al. Clinical and in vitro effect of dornase alfa in mechanically ventilated pediatric non-cystic fibrosis patients with atelectases. Cell Physiol Biochem 2009; 23: 205–210.Google Scholar
2. Riethmueller, J, Borth-Bruhns, T, Kumpf, M, et al. Recombinant human deoxyribonuclease shortens ventilation time in young, mechanically ventilated children. Pediatr Pulmonol 2006; 4: 61–66.Google Scholar
3. Peroni, DG, Boner, AL. Atelectasis: mechanisms, diagnosis and management. Paediatr Respir Rev 2000; 1: 274–278.Google Scholar
4. Boeuf, B, Prouix, F, Morneau, S, Marton, D, Lacroix, J. Safety of endotracheal rh DNase (Pulmozyme) for treatment of pulmonary atelectasis in mechanically ventilated children. Pediatr Pulmonol 1998; 26: 147.Google Scholar
5. Quan, JM, Tiddens, HA, Sy, JP, et al. Pulmozyme Early Intervention Trial Study Group: a two-year randomized, placebo-controlled trial of dornase alfa in young patients with cystic fibrosis with mild lung function abnormalities. J Pediatr 2001; 139: 813–820.Google Scholar
6. Jenkins, KJ, Gauvreau, K, Newburger, JW, Spray, TL, Moller, JH, Iezzoni, LI. Consensus-based method for risk adjustment for surgery for congenital heart disease. J Thorac Cardiovasc Surg 2002; 123: 110–118.Google Scholar
7. Merkus, PJ, de Hoog, M, van Gent, R, de Jongste, JC. DNase treatment for atelectasis in infants with severe respiratory syncytial virus bronchiolitis. Eur Respir J 2001; 18: 734–737.Google Scholar
8. Hendriks, T, de Hoog, M, Lequin, MH, Devos, AS, Merkus, PJ. DNase and atelectasis in non-cystic fibrosis pediatric patients. Crit Care 2005; 9: R351–R356.Google Scholar
9. Erdeve, O, Uras, N, Atasay, B, Arsan, S. Efficacy and safety of nebulized recombinant human DNase as rescue treatment for persistent atelectasis in newborns: case-series. Croat Med J 2007; 48: 139–144.Google Scholar
10. El Hassan, NO, Chess, PR, Huysman, MW, Merkus, PJ, de Jongste, JC. Rescue use of DNase in critical lung atelectasis and mucus retention in premature neonates. Pediatrics 2001; 108: 468–470.Google Scholar
11. Bryson, HM, Sorkin, EM. Dornase alfa. A review of its pharmacological properties and therapeutic potential in cystic fibrosis. Drugs 1994; 48: 894–906.Google Scholar