Utilidad de alfa-dornasa en el tratamiento de atelectasias en recién nacidos en estado crítico.

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Bibliographic Details
Title:	Utilidad de alfa-dornasa en el tratamiento de atelectasias en recién nacidos en estado crítico.
Alternate Title:	Usefulness of dornase alpha in the treatment of atelectasis in critically ill newborns.
Authors:	Fernández-Méndez, Jacqueline¹, Berumen-Lechuga, María Guadalupe², Moreno-Álvarez, Óscar³, Ramírez-Valenzuela, Karla Leticia⁴, Molina-Pérez, Carlos José⁵ carlos.molinap@imss.gob.mx
Source:	Revista Mexicana de Pediatria. sep/oct2025, Vol. 92 Issue 5, p174-179. 6p.
Subjects:	ATELECTASIS, INTRATRACHEAL drug administration, ARTIFICIAL respiration, NEONATAL intensive care, RESPIRATORY therapy, NEONATOLOGY, RETROSPECTIVE studies, OXYGEN in the blood
Abstract (English):	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. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	Introducción: los recién nacidos (RN) críticamente enfermos bajo ventilación mecánica tienen alto riesgo de desarrollar atelectasias debido a la acumulación de secreciones viscosas. La alfa-dornasa ha surgido como terapia coadyuvante para reducir la viscosidad de las secreciones y mejorar la función pulmonar. Objetivo: evaluar el efecto clínico de la alfa-dornasa administrada por vía intratraqueal en RN con atelectasias refractarias, que se encuentran asistidos con ventilación mecánica. Material y métodos: estudio observacional y retrospectivo en 29 neonatos. Se incluyeron pacientes con atelectasias persistentes > 48 horas, a pesar de fisioterapia. La alfa-dornasa se administró en dosis de 1 mg/m² cada 12 horas. Se evaluó la fracción inspirada de oxígeno (FiO2), presión arterial de dióxido de carbono (PaCO2), resolución radiológica de atelectasias y los efectos adversos. Resultados: la mediana de edad al inicio del tratamiento fue de ocho días, predominaron pacientes masculinos (58.6%). Se observó mejoría significativa en FiO2 (62.7 vs 24.3%, p < 0.001), PaCO2 (64.2 vs 49.3 mmHg, p < 0.001) y presión inspiratoria pico (17 vs 12 cmH2O, p < 0.001). En la mayoría hubo resolución radiológica al quinto día del tratamiento. No se registraron muertes. Conclusión: la alfa-dornasa intratraqueal parece mejorar la oxigenación en neonatos críticamente enfermos con atelectasias refractarias. Se requieren estudios prospectivos aleatorizados para confirmar estos hallazgos. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
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. [ABSTRACT FROM AUTHOR]
ISSN:	00350052
DOI:	10.35366/122096