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首页> 外文期刊>Critical care : >DNase and atelectasis in non-cystic fibrosis pediatric patients.
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DNase and atelectasis in non-cystic fibrosis pediatric patients.

机译：非囊性纤维化儿科患者的DNase和肺不张。

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INTRODUCTION: No evidence based treatment is available for atelectasis. We aimed to evaluate the clinical and radiologic changes in pediatric patients who received DNase for persistent atelectasis that could not be attributed to cardiovascular causes, and who were unresponsive to treatment with inhaled bronchodilators and physiotherapy. METHODS: All non-cystic fibrosis pediatric patients who received nebulised or endotracheally instilled DNase for atelectasis between 1998 and 2002, with and without mechanical ventilation, were analysed in a retrospective descriptive study. The endpoints were the blood pCO2, the heart rate, the respiratory rate, the FiO2 and the chest X-ray scores before and after treatment. RESULTS: In 25 of 30 patients (median [range] age, 1.6 [0.1-11] years) who met inclusion criteria, paired data of at least three endpoints were available. All clinical parameters improved significantly within 2 hours (P < 0.01), except for the heart rate (P = 0.06). Chest X-ray scores improved significantly within 24 hours after DNase treatment (P < 0.001). Individual improvement was observed in 17 patients and no clinical change was observed in five patients. Temporary deterioration (n = 3) was associated with increased airway obstruction and desaturations. No other complications were observed. CONCLUSION: After treatment with DNase for atelectasis of presumably infectious origin in non-cystic fibrosis pediatric patients, rapid clinical improvement was observed within 2 hours and radiologic improvement was documented within 24 hours in the large majority of children, and increased airway obstruction and ventilation-perfusion mismatch occurred in three children, possibly due to rapid mobilisation of mucus. DNase may be an effective treatment for infectious atelectasis in non-cystic fibrosis pediatric patients.
机译：引言：目前尚无基于证据的肺不张治疗。我们的目的是评估接受DNase治疗的持久性肺不张的儿科患者的临床和放射学变化，这些原因不能归因于心血管原因，并且对吸入性支气管扩张药和物理疗法无反应。方法：回顾性描述性研究分析了1998年至2002年之间接受雾化或气管内滴注DNase治疗肺不张的所有非囊性纤维化儿科患者，无论是否进行机械通气。终点是治疗前后的血液pCO2，心率，呼吸率，FiO2和胸部X线评分。结果：在符合纳入标准的30例患者中（年龄[中] [范围]为1.6 [0.1-11]岁）中有25例具有至少三个终点的配对数据。除心率（P = 0.06）外，所有临床参数均在2小时内显着改善（P <0.01）。 DNase治疗后24小时内，胸部X线评分显着改善（P <0.001）。在17例患者中观察到个体改善，在5例患者中未观察到临床变化。暂时恶化（n = 3）与气道阻塞和脱饱和增加有关。没有观察到其他并发症。结论：用DNase治疗非囊性纤维化儿科患者可能是传染源性肺不张后，大多数儿童在2小时内观察到临床快速改善，并在24小时内发现放射学改善，并且气道阻塞和通气增加- 3名儿童发生灌注不匹配，可能是由于粘液的快速动员。 DNase可能是治疗非囊性纤维化儿科患者肺不张的有效方法。

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