Resolution of mucus plugging and atelectasis after intratracheal rhDNase therapy in a mechanically ventilated child with refractory status asthmaticus

Citation
A. Durward et al., Resolution of mucus plugging and atelectasis after intratracheal rhDNase therapy in a mechanically ventilated child with refractory status asthmaticus, CRIT CARE M, 28(2), 2000, pp. 560-562
Citations number
8
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Aneshtesia & Intensive Care
Journal title
CRITICAL CARE MEDICINE
ISSN journal
0090-3493 → ACNP
Volume
28
Issue
2
Year of publication
2000
Pages
560 - 562
Database
ISI
SICI code
0090-3493(200002)28:2<560:ROMPAA>2.0.ZU;2-Q
Abstract
Objective: To report the dramatic resolution of unilateral mucus plugging a nd atelectasis in a mechanically ventilated child with refractory status as thmaticus after intratracheal recombinant human DNase (rhDNase) therapy, Design: Case report, Setting: Critical care unit, Patient: A 7-yr-old boy with status asthmaticus, severe respiratory failure and barotrauma unresponsive to conventional therapy, Fiberoptic bronchosco py confirmed widespread mucus impaction of the subsegmental bronchi of the left lung without response to bronchoscopic lavage. interventions: Two 10-mg doses of intratracheal rhDNase were administered 8 hrs apart. Main Results: The left-sided atelectasis resolved 3 hrs after the first dos e of rhDNase, Improvements in gas exchange and tidal volumes were sustained and particularly noticeable after the second dose, The patient was success fully extubated 26 hrs after receiving the rhDNase treatment without any ad verse effects, Conclusions: rhDNase should be considered as a potential therapy for refrac tory mucus plugging and atelectasis in intubated patients with status asthm aticus.