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首页> 外文期刊>Cellular Physiology and Biochemistry >Clinical and in vitro Effect of Dornase Alfa in Mechanically Ventilated Pediatric Non-Cystic Fibrosis Patients with Atelectases
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Clinical and in vitro Effect of Dornase Alfa in Mechanically Ventilated Pediatric Non-Cystic Fibrosis Patients with Atelectases

机译：机械通气的小儿非囊性纤维化伴单宁酶的Dornase Alfa的临床和体外作用

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Introduction: At present no evidence-based medical treatment for persistent atelectasis in pediatric non-cystic fibrosis (CF) patients is available. Method: To evaluate the use of intratracheally instilled recombinant human deoxyribonuclease (rhDNase) in intubated and ventilated pediatric patients, we performed a single-center observational study on 46 pediatric intensive care patients who had received intratracheal DNase. Patients were classified, according to radiologic findings of atelectasis (group 1) or infiltrates. As controls we examined a historical control group of 17 patients with atelectasis after cardiac surgery, who had been treated with NaCl 0.9% and matched for age and diagnosis with 21 patients from group 1 (subgroup 1a). Radiologic improvement and inflammatory markers in both serum and tracheal aspirates were measured. Results: In group 1, 35 patients had 51 atelectases/dystelectases episodes at baseline. 67 % of patients showed radiologic signs of improvement after 24h treatment with rhDNase. In subgroup 1a, 16 patients had complete resolution of atelectases and minimal change in dystelectases after a treatment of 24 hours rhDNase, compared with the control group of 17 patients, who had 7 atelectases and 10 dystelectases at baseline and an improvement in only 1 out of 17 (6 %) patients after 24h. Conclusion: Intratracheal instillation of rhDNase is an effective adjunct to conservative therapy of atelectases in children. Further randomized controlled prospective studies are necessary.
机译：简介：目前尚无针对儿童非囊性纤维化（CF）患者持续性肺不张的循证医学治疗方法。方法：为了评估气管内滴注的重组人脱氧核糖核酸酶（rhDNase）在插管和通气儿科患者中的使用，我们对46例接受气管内DNase的儿科重症监护患者进行了单中心观察性研究。根据肺不张（第1组）或浸润的影像学发现对患者进行分类。作为对照，我们检查了一个历史对照组，其中有17名心脏手术后肺不张患者，他们接受过0.9％的NaCl治疗，并与年龄和诊断相匹配的第1组（21a组）有21名患者。测量了血清和气管抽吸物中的放射学改善和炎性标志物。结果：在第1组中，有35例患者在基线时发生了51种肺不张/血脂异常。 rhDNase治疗24小时后，有67％的患者表现出放射学改善迹象。在1a亚组中，经过24小时rhDNase的治疗后，有16例患者具有完全的不固定化酶和反浓缩酶的最小变化，相比之下，对照组的17例患者在基线时具有7种不溶酶和10个反置换酶，仅改善了1例24小时后17例（6％）。结论：气管内滴入rhDNase是保守治疗儿童不育症的有效辅助手段。进一步的随机对照前瞻性研究是必要的。

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