SUCCESFUL TREATMENT OF POSTOPERATİVE ATELECTASİS WİTH DORNASE ALPHA (PULMOZYME®) AFTER CONGENİTAL HEART SURGERY İN A NEWBORN

Abstract

12 day male patient followed with supracardiac total anomalous pulmonary venous connection (TAPVC) was admitted to our service after one day of surgical repair .The patient extubation attempts failed three times because of the atelectasis occurred in the lungs. As conventional therapy failed to improve Atelectasis, dornase alpha was tested via intubation cannula . It avoided the recurrence of atelectasis and the patient was discharged with no oxygen .

Keywords

• atelectasis
• dornase alpha (pulmozyme)
• congenital heart disease

SUCCESFUL TREATMENT OF POSTOPERATIVE ATELECTASIS WITH DORNASE ALPHA (PULMOZYME®) AFTER CONGENITAL HEART SURGERY IN A NEWBORN

Abstract

12 day male patient followed with supracardiac total anomalous pulmonary venous connection (TAPVC) was admitted to our service after one day of surgical repair .The patient extubation attempts failed three times because of the atelectasis occurred in the lungs after the surgery. Atelectasis was treated with installed dornase alpha. It avoided the recurrence of atelectasis and the patient was discharged with no oxygen .

Keywords

• Atelektazi
• dornaz alfa
• konjeniatl kalp hastalığı

References

1. 1. Centers for Disease Control and Prevention (CDC). Racial differences by gestational age in neonatal deaths attributable to congenital heart defects—United States, 2003–2006. MMWR Morb Mortal Wkly Rep. 2010;59(37): 1208–1211
2. 2. Narayen IC, Blom NA, Ewer AK et al. Aspects of pulse oximetry screening for critical congenital heart defects: when, how and why. Arch Dis Child Fetal Neonatal Ed 2016; 101: F162–67
3. 3. F. Healy ,B.D. Hanna, R. Zinman. Pulmonary Complications of Congenital Heart Disease Paediatric Respiratory Reviews 13 (2012) 10–15
4. 4. Andrejaitiene J, Sirvinskas E, Bolys R. The influence of cardiopulmonary bypass on respiratory dysfunction in early postoperative period. Medicina (Kaunas). 2004; 40(Suppl1):7-12.
5. 5. Kavanagh BP. Perioperative atelectasis. Minerva Anestesiol. 2008; 74(6):285-7.
6. 6. Quan JM, Tiddens HA, Sy JP Pulmozyme Early Intervention Trial Study Group: A two-year randomized, placebo-controlled trial of dornase alfa in young patients with cystic fibrosis with mild lung function abnormalities. J Pediatr 2001, 139:813-820.
7. 7. F. Healy ,B.D. Hanna, R. Zinman. Pulmonary Complications of Congenital Heart Disease Paediatric Respiratory Reviews 2011
8. 8. Peroni DG, Boner AL: Atelectasis: mechanisms, diagnosis and management. Paediatr Respir Rev 2000, 1:274-278.

9. 9. Fok TF. Adjunctive pharmacotherapy in neonates with respiratory failure. Semin Fetal Neonat Med 2009; 14: 49–55.
10. 10. Kupeli S, Teksam O, Dogru D, Yurdakok M. Use of recombinant human DNase in a premature infant with recurrent atelectasis. Pediatr Int. 2003;45:584-6.
11. 11. Fitzgerald DA, Hilton J, Jepson B, Smith L. A crossover, randomized, controlled trial of dornase alfa before versus after physiotherapy in cystic fibrosis. Pediatrics. 2005;116: e549-54.
12. 12. Riethmueller J, Kumpf M, Borth-Bruhns T, et al. Clinical and in vitro effect of dornase alfa in mechanically ventilated pediatric non-cystic fibrosis patients with atelectases. Cell Physiol Biochem 2009; 23: 205–210.
13. 13. Erdeve O, Uras N, Atasay B, et al. Efficacy and safety of nebulized recombinant human DNAase as rescue treatment for persistent atelectasis in newborns: case-series. Croat Med J 2007; 48: 234–129.
14. 14. El Hassan NO, Chess PR, Huysman MWA, et al. Rescue use of DNase in critical lung atelectasis and mucus retention in premature neonates. Pediatrics 2001;108; 468–470.