Dornase Alfa in Premature Infants With Severe Respiratory Distress and Early Bronchopulmonary Dysplasia

Reiter, Pamela D.; Townsend, Susan F.; Velasquez, Rachelle

doi:10.1038/sj.jp.7200456

Cited by 14 publications

(11 citation statements)

References 10 publications

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“…18 To date, only a few groups have published reports about the successful use of dornase alfa in the treatment of mechanically ventilated children. 14,19,20 However, none of these studies was a randomized controlled trial.…”

Section: Introductionmentioning

confidence: 99%

Recombinant Human Deoxyribonuclease Shortens Ventilation Time in Young, Mechanically Ventilated Children

Riethmueller

Borth-Bruhns

Kumpf

et al. 2005

Pediatric Pulmonology

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Summary. Recombinant human deoxyribonuclease I (dornase alfa) is currently used as an inhaled mucoactive agent in the treatment of cystic fibrosis. In a randomized, placebo-controlled, double-blind clinical study in 100 infants, we investigated whether the therapeutic use of dornase alfa can be extended to ventilated, fluid-restricted children to reduce reintubation rate, ventilation duration, pediatric intensive care unit (PICU) stay, and ventilation complications. While reintubation rates were similar for dornase alfa 7% vs. placebo 9% (odds ratio, 0.77; confidence interval, 0.11-4.9), the incidence of atelectasis (6 vs. 17, respectively; P-value 0.051), median ventilation time (2.2 vs. 3.4 days, respectively; P-value 0.043), median length of PICU stay (7 vs. 8 days, respectively; P-value 0.051), and mean costs (s4,830 vs. s6,320, respectively) were lower in the dornase alfa group. No adverse effects were observed, even in critically ill patients. We found that dornase alfa was beneficial and safe. Our findings also indicate that dornase alfa is possibly of value from the first day of mechanical ventilation onward, particularly when longer ventilation (>3 days) is expected in fluid-restricted children after cardiac surgery.

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Section: Introductionmentioning

confidence: 99%

Recombinant Human Deoxyribonuclease Shortens Ventilation Time in Young, Mechanically Ventilated Children

Riethmueller

Borth-Bruhns

Kumpf

et al. 2005

Pediatric Pulmonology

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“…There are limited data available about its use in premature infants in CF and non-CF patients. Reiter and El Hasseen 6,7 reported on dornase alfa use in premature infants without CF and found that dornase decreased oxygen requirements, decreased mechanical ventilation needs and helped in reestablishing airway patency in premature neonates, with critical pulmonary collapse, secondary to mucous plugging.…”

Section: Discussionmentioning

confidence: 99%

Cystic fibrosis in premature infants

Engmann

Moya

et al. 2011

J Perinatol

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“…RhDNase treatment also improved ventilator settings, oxygen requirement, and sputum appearance in a series of ventilated, low birth weight infants with early BPD with acute pneumonia or mucus plugging. 68 It was also reported to have beneficial effects on chest radiographs, respiratory rate, blood gas values, and oxygen requirement in a large series (n ¼ 30) of hospitalized children with atelectasis. 69 Finally, in another series, rhDNase improved findings on physical examination, blood gas values, chest radiographs, and oxygen requirement in infants with severe RSV bronchiolitis and atelectasis.…”

Section: Atelectasis/mucus Pluggingmentioning

confidence: 96%

Pharmacotherapy of impaired mucociliary clearance in non‐CF pediatric lung disease. A review of the literature

Boogaard

Jongste

Merkus

2007

Pediatric Pulmonology

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Mucoactive agents are used to treat a variety of lung diseases involving impaired mucociliary clearance or mucus hypersecretion. The mucoactive agents studied most frequently are N-acetylcysteine (NAC), recombinant human DNase (rhDNase), and hypertonic saline. Studies on the efficacy of these have been mainly conducted in adults, and in patients with cystic fibrosis (CF). The exact role of mucoactive agents in children with non-CF lung disease is not well established. We present an overview of the current literature reporting clinical outcome measures of treatment with NAC, rhDNase, and hypertonic saline in children.

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Dornase Alfa in Premature Infants With Severe Respiratory Distress and Early Bronchopulmonary Dysplasia

Cited by 14 publications

References 10 publications

Recombinant Human Deoxyribonuclease Shortens Ventilation Time in Young, Mechanically Ventilated Children

Recombinant Human Deoxyribonuclease Shortens Ventilation Time in Young, Mechanically Ventilated Children

Cystic fibrosis in premature infants

Pharmacotherapy of impaired mucociliary clearance in non‐CF pediatric lung disease. A review of the literature

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