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2025, Number 5

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Rev Mex Pediatr 2025; 92 (5)

Usefulness of dornase alpha in the treatment of atelectasis in critically ill newborns

Fernández-Méndez J, Berumen-Lechuga MG, Moreno-Álvarez Ó, Ramírez-Valenzuela KL, Molina-Pérez CJ

Language: Spanish
References: 23
Page: 174-179
PDF size: 567.76 Kb.


ABSTRACT

Introduction: critically ill newborns on mechanical ventilation are at high risk of developing atelectasis due to the accumulation of viscous secretions. Dornase alpha has emerged as an adjunctive therapy to reduce the viscosity of secretions and improve lung function. Objective: to evaluate the clinical effect of dornase alpha administered intratracheally in newborns with refractory atelectasis who are receiving mechanical ventilation. Material and methods: this was a retrospective observational study of 29 neonates. Patients with persistent atelectasis (> 48 hours) despite physiotherapy were included. Dornase alpha was administered at a dose of 1 mg/m2 every 12 hours. The fraction of inspired oxygen (FiO2), partial pressure of carbon dioxide (PaCO2), radiological resolution of atelectasis, and adverse effects were evaluated. Results: the median age at the start of treatment was eight days, and male patients predominated (58.6%). Significant improvements were observed in FiO2 (62.7 vs. 24.3%, p < 0.001), PaCO2 (64.2 vs. 49.3 mmHg, p < 0.001), and peak inspiratory pressure (17 vs. 12 cmH2O, p < 0.001). Radiological resolution was observed in most patients by the fifth day of treatment. No deaths were recorded. Conclusion: intratracheal dornase alpha appears to improve oxygenation in critically ill neonates with refractory atelectasis. Prospective randomized studies are needed to confirm these findings.


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