title: Safety of recombinant human deoxyribonuclease as a rescue treatment for persistent atelectasis in newborns.
abstract: OBJECTIVE
  Pulmonary problems are vitally important in newborns. Increased intense and mucoid secretions may lead to atelectasis, pulmonary infections, respiratory distress, prolonged mechanical ventilation or even death. The aim of this study was to evaluate the safety of recombinant human deoxyribonuclease (rhDNase) in the management of persistent atelectasis in term and preterm newborns, unresponsive to the conventional treatment.
  
  
  METHODS
  Prospective study of patients admitted to a general community setting of a neonatal intensive care unit between December 2007 and December 2009.
  
  
  METHODS
  The study included 22 patients (12 premature and 10 term) who were admitted to the neonatal intensive care unit because of respiratory distress and developed atelectasis, and were unresponsive to conventional treatment. Nebulized rhDNase was administered to all patients at a dose of 1 mg/m2 twice daily for 3 days. In patients who did not respond to 3 days of treatment, endotracheal rhDNase was administered at a dose of 1 mg/m2. We assessed the clinical (respiratory rate and oxygen requirement) and radiologic responses (chest radiographic score), recurrence of atelectasis, the need for a repetitive treatment, and mortality rate.
  
  
  RESULTS
  A clinical and radiologic improvement of atelectasis was observed in 18 of 22 patients following 3 days of nebulized rhDNase treatment. Atelectasis relapsed in 4 patients. Following the administration of combined endotracheal and nebulized rhDNase treatment, an improvement of atelectasis was noted in all four recurrent cases. No adverse events were observed in patients because of the rhDNase treatment.
  
  
  CONCLUSIONS
  rhDNase treatment is a safe option and may be used as an effective method for the management of persistent atelectasis in newborns, which is resistant to other conventional treatment methods.
authors.affiliation: Pediatrics Clinic, Atlas Hospital, Umraniye, Istanbul. atyfedakar@hotmail.com
authors.forename: Atiye
authors.initials: A
authors.lastname: Fedakar
authors.forename: Cavit
authors.initials: C
authors.lastname: Aydogdu
authors.forename: Ali
authors.initials: A
authors.lastname: Fedakar
authors.forename: Murat
authors.initials: M
authors.lastname: Ugurlucan
authors.forename: Semih
authors.initials: S
authors.lastname: Bolu
authors.forename: Marina
authors.initials: M
authors.lastname: Iskender
mesh_terms: D000280:Administration, Inhalation; D003850:Deoxyribonuclease I / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D011446:Prospective Studies; D001261:Pulmonary Atelectasis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography; D011994:Recombinant Proteins / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D011994:Recombinant Proteins; D003850:Deoxyribonuclease I; C568813:dornase alfa