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

Pediatrics International, 05/01/2012

Altunhan H et al. – Although both the combined treatment with recombinant human DNase (rhDNase) and hypertonic saline (HS) and their monotherapies are effective in the treatment of persistent atelectasis in newborns receiving mechanical ventilation, their combined use produces higher efficacy. The efficacy of rhDNase is superior to monotherapy with HS. Use of these two treatments concomitantly reduces the cost.

Methods

  • Eighty-seven newborns with persistent atelectasis who did not respond to traditional treatment were studied retrospectively. Group 1 did not receive nebulizer drugs; Group 2 received 7%HS; Group 3 received rhDNase; and Group 4 received both 7%HS and rhDNase.
  • Subjects' chest X-ray scores, partial pressure of CO2, respiratory rate, fraction of inspired oxygen (FiO2) peak inspiratory pressure, atelectasis healing rate, median duration of nebulizer treatment and costs were compared.

Results

  • Percentages of improvement in atelectasis on Day 3 of treatment in Group 1, Group 2, Group 3 and Group 4 were 27, 70, 81 and 95%, respectively, while median duration of treatment was 8.1, 3.3, 2.9 and 2.4 days, respectively.
  • Comparison of chest X-ray scores, partial pressure of CO2, respiratory rate, FiO2 and peak inspiratory pressure values before and 48 h after treatment did not yield a significant difference for the control group (P > 0.05), while a marked improvement was observed in other groups for all parameters (P < 0.05).
  • The most distinct improvement was in Group 4, followed by Group 3.

Print Article Summary Cat 2 CME Report