Effect of using dornase alfa versus bronchoscopy as treatment of persistent atelectasis in children with congenital heart disease: a retrospective study
Efecto del uso de dornasa alfa versus fibrobroncoscopía como tratamiento de atelectasias persistentes en niños con cardiopatía congénita: Un estudio retrospectivo
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Objetives: To evaluate the effect of using dornase alfa versus bronchoscopy as a treatment for persistent atelectasis in children with congenital heart disease. Methods: A retrospective cohort study was carried out with the information in the clinical history of children with congenital heart disease and persistent atelectasis hospitalized at Instituto Nacional de Salud del Niño San Borja in 2016 and 2017, treated with bronchoscopy of dornase alfa. The outcome was the atelectasis score assessed on chest X-ray before and after treatment. Chi2 and paired T-student tests were used to assess the association between the variables. Results: Of the 43 patients, 60.5% received treatment with dornase alfa and the rest underwent to bronchoscopy. 23 (53.5%) patients were women and the median age was 5 months. After performing bronchoscopy, there was a statistically significant decrease in respiratory rate (p<0.05). The radiographic score should be after treatment with dornase alfa an bronchoscopy, from 3.9 (SD: 2.4) to 2.9 (SD: 2.1), p<0.05 and from 5.5 (SD: 2.5) to 3.9 (2.1), p<0.05, respectively. No differences were found in adverse effects after both procedures. Conclusion: Both dornase alfa and bronchoscopy were useful in
the management of persistent atelectasis in children with congenital heart disease without differences in adverse effects.
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Woodring JH, Reed JC. Types and mechanisms of pulmonary atelectasis. J Thorac Imaging. 1996;11(2):92-108. doi: 10.1097/00005382-199621000-00002
Peroni DG, Boner AL. Atelectasis: mechanisms, diagnosis and management. Paediatr Respir Rev. 2000;1(3):274-8. doi: 10.1053/prrv.2000.0059
Ozturk E, Tanidir IC, Haydin S, Onan IS, Odemis E, Bakir I. The use of dornase alpha for post-operative pulmonary atelectasis after congenital heart surgery. Cardiol Young. 2014;24(5):807-12. doi: 10.1017/S1047951113001078
Hendriks T, de Hoog M, Lequin MH, Devos AS, Merkus PJ. DNase and atelectasis in non-cystic fibrosis pediatric patients. Crit Care. 2005;9(4):R351-6. doi: 10.1186/cc3544
Crescimanno G, Marrone O. Successful treatment of atelectasis with Dornase alpha in a patient with congenital muscular dystrophy. Rev Port Pneumol. 2014;20(1):42-5. doi: 10.1016/j.rppneu.2012.12.002
Riethmueller J, Borth-Bruhns T, Kumpf M, Vonthein R, Wiskirchen J, Stern M, et al. Recombinant human deoxyribonuclease shortens ventilation time in young, mechanically ventilated children. Pediatr Pulmonol. 2006;41(1):61-6. doi: 10.1002/ppul.20298
Altunhan H, Annagür A, Pekcan S, Ors R, Koç H. Comparing the efficacy of nebulizer recombinant human DNase and hypertonic saline as monotherapy and combined treatment in the treatment of persistent atelectasis in mechanically ventilated newborns. Pediatr Int. 2012;54(1):131-6. doi: 10.1111/j.1442-200X.2011.03519.x
Thornby KA, Johnson A, Axtell S. Dornase Alfa for Non-Cystic Fibrosis Pediatric Pulmonary Atelectasis. Ann Pharmacother. 2014;48(8):1040-9. doi: 10.1177/1060028014535199
Toolsie OG, Adrish M, Zaidi SAA, Diaz-Fuentes G. Comparative outcomes of inpatients with lung collapse managed by bronchoscopic or conservative means. BMJ Open Respir Res. 2019;6(1):e000427. doi: 10.1136/bmjresp-2019-000427
Carroll C, Slattery DM. Paediatric flexible bronchoscopy and its indications. Ir Med J. 2010;103(10):305-7.
Talamoni HL, Pisapia ND, Buendía JA. Broncoscopía flexible en niños con atelectasias persistentes. Serie de casos. Arch Argent Pediatr. 2015; 113:106-8. doi: 10.5546/aap.2015.e106
Dilmen U, Karagol BS, Oguz SS. Nebulized hypertonic saline and recombinant human DNase in the treatment of pulmonary atelectasis in newborns. Pediatr Int. 2011;53(3):328-31. doi: 10.1111/j.1442-200X.2010.03245.x
Torbic H, Hacobian G. Evaluation of Inhaled Dornase Alfa Administration in Non-Cystic Fibrosis Patients at a Tertiary Academic Medical Center. J Pharm Pract. 2016;29(5):480-3. doi: 10.1177/0897190014568385
Woodhull S, Goh Eng Neo A, Tang Poh Lin J, Chay OM Pediatric Flexible Bronchoscopy in Singapore: A 10-year Experience. J Bronchology Interv Pulmonol. 2010;17(2):136-41. Doi: 10.1097/LBR.0b013e3181dc993a
