DNase and atelectasis in non-cystic fibrosis pediatric patients.
DNase and atelectasis in non-cystic fibrosis pediatric patients.
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DOI：
10.1186/cc3544
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发表时间：
2005-08
期刊：
影响因子：
--
通讯作者：
Merkus PJ
中科院分区：
文献类型：
--
作者：
Hendriks T;de Hoog M;Lequin MH;Devos AS;Merkus PJ
目前尚无针对肺不张的循证治疗方法。我们的目的是评价接受DNA酶治疗不能归因于心血管原因的持续性肺不张的儿科患者的临床和放射学变化，这些患者对吸入性支气管扩张剂和物理治疗无反应。在一项回顾性描述性研究中，分析了1998年至2002年期间接受雾化或气管内滴注DNA酶治疗肺不张的所有非囊性纤维化儿科患者（伴或不伴机械通气）。观察两组治疗前后的血二氧化碳分压（pCO 2）、心率、呼吸频率、氧合指数（FiO 2）及胸部X线评分。在30例符合入选标准的患者中，有25例（中位[范围]年龄为1.6 [0.1-11]岁）至少有3个终点的配对数据可用。除心率（P = 0.06）外，其他临床指标均在2小时内明显改善（P <0.01）。DNase治疗后24小时内胸部X线评分明显改善（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。暂时性恶化（n = 3）与气道阻塞和去饱和度增加相关。未观察到其他并发症。在非囊性纤维化儿科患者中使用DNA酶治疗可能是感染性原因的肺不张后，在2小时内观察到快速临床改善，在大多数儿童中在24小时内记录到放射学改善，在3名儿童中发生气道阻塞和通气-灌注不匹配增加，可能是由于粘液的快速动员。脱氧核糖核酸酶可能是治疗非囊性纤维化儿科患者感染性肺不张的有效方法。
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. 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. 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. 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.
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影响因子：
6.7
作者：
BABCOOK, CJ;NORMAN, GR;COBLENTZ, CL
通讯作者：
COBLENTZ, CL
影响因子：
3.1
作者：
Nasr, SZ;Kuhns, LR;Strouse, PJ
通讯作者：
Strouse, PJ
影响因子：
5.8
作者：
Peroni, D G;Boner, A L
通讯作者：
Boner, A L
DOI：
10.1111/j.1651-2227.1990.tb11442.x
发表时间：
1990-02-01
期刊：
ACTA PAEDIATRICA SCANDINAVICA
影响因子：
--
作者：
FRIIS, B;EIKEN, M;JENSEN, A
通讯作者：
JENSEN, A
影响因子：
10
作者：
PICOT, R;DAS, I;REID, L
通讯作者：
REID, L