{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:09:46Z","timestamp":1753888186492,"version":"3.41.2"},"reference-count":16,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. paul. pediatr."],"abstract":"<jats:p>ABSTRACT Objective: Dornase alfa (rhDNase) reduces the viscosity of purulent sputum in the lungs. The use in patients with cystic fibrosis (CF) is proven. However, the evidence of its applicability to other conditions is limited. This study aims to present the authors\u2019 experience with the use of rhDNase in non-CF patients admitted to the Pediatric Intensive Care Unit (PICU). At the study center, rhDNase was used during flexible bronchoscopies in 24 cases, of which 20 (83%) had atelectasis and seven (29%) were admitted to PICU. Four patients (57%) were on invasive mechanical ventilation (MV). Case description: Two cases of daily rhDNase administration at PICU are presented: patient A was an 8-year-old boy admitted with septic shock and acute respiratory distress syndrome (ARDS). The patient required mechanical ventilation with aggressive settings and experienced several clinical complications. On D50, he started rhDNase treatment with an improvement in FiO2, PaCO2 and PaO2\/FiO2 ratio according to radiologic findings. He was extubated on D23 of treatment. Patient B was a 17-month-old girl admitted with a convulsive status epilepticus who experienced respiratory complications (infectious and barotrauma) with ARDS, requiring aggressive ventilation. She initiated rhDNase treatment on D60. During the treatment an improvement in FiO2, PaO2\/FiO2 ratio and a tendency of PaCO2 decrease were found. She had radiological improvement. No complications were described. Comments: RhDNase may be a helpful and safe tool to use in PICU prolonged intubated patients with ventilator-induced lung injury. Further studies are needed to assess and propose valid indications.<\/jats:p>","DOI":"10.1590\/1984-0462\/2022\/40\/2020169","type":"journal-article","created":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T12:02:40Z","timestamp":1630497760000},"source":"Crossref","is-referenced-by-count":1,"title":["Use of recombinant human deoxyribonuclease in pediatric intensive care unit \u2013 a single-center experience"],"prefix":"10.1590","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2377-7731","authenticated-orcid":false,"given":"Daniel","family":"Meireles","sequence":"first","affiliation":[{"name":"Centro Hospitalar Universit\u00e1rio do Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1068-8884","authenticated-orcid":false,"given":"Sofia Ribeiro","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Universit\u00e1rio do Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5397-0057","authenticated-orcid":false,"given":"Alzira","family":"Sarmento","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Universit\u00e1rio do Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4641-2898","authenticated-orcid":false,"given":"Telma","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Universit\u00e1rio do Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9477-8822","authenticated-orcid":false,"given":"Manuel Ferreira","family":"Magalh\u00e3es","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Universit\u00e1rio do Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3328-5666","authenticated-orcid":false,"given":"Ana","family":"Ramos","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Universit\u00e1rio do Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6662-4412","authenticated-orcid":false,"given":"Paula Cristina","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Universit\u00e1rio do Porto, Portugal"}]}],"member":"530","published-online":{"date-parts":[[2022]]},"reference":[{"key":"ref1","first-page":"CD008395","article-title":"Nebulised deoxyribonuclease for viral bronchiolitis in children younger than 24 months","volume":"11","author":"Enriquez A","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"ref2","first-page":"65","article-title":"Dornase alfa for cystic fibrosis","volume":"21","author":"Yang CL","year":"2017","journal-title":"Paediatr Respir Rev"},{"key":"ref3","first-page":"CD001127","article-title":"Dornase alfa for cystic fibrosis","volume":"9","author":"Yang C","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1002\/ppul.20298","article-title":"Recombinant human deoxyribonuclease shortens ventilation time in young, mechanically ventilated children","volume":"41","author":"Riethmueller J","year":"2006","journal-title":"Pediatr Pulmonol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1159\/000204109","article-title":"Clinical and in vitro effect of dornase alfa in mechanically ventilated pediatric non-cystic fibrosis patients with atelectases","volume":"23","author":"Riethmueller J","year":"2009","journal-title":"Cell Physiol Biochem"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"R351","DOI":"10.1186\/cc3544","article-title":"DNase and atelectasis in non-cystic fibrosis pediatric patients","volume":"9","author":"Hendriks T","year":"2005","journal-title":"Crit 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DNase in critical lung atelectasis and mucus retention in premature neonates","volume":"18","author":"El Hassan N","year":"2001","journal-title":"Pediatrics"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1002\/(SICI)1099-0496(199808)26:2<147::AID-PPUL14>3.0.CO;2-1","article-title":"Letter to the editor","volume":"26","author":"Boeuf B","year":"1998","journal-title":"Pediatr Pulmonol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1080\/17476348.2017.1358089","article-title":"The use of pulmonary clearance medications in the acutely ill patient","volume":"11","author":"Papacostas MF","year":"2017","journal-title":"Expert Rev Respir Med"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.4187\/respcare.04165","article-title":"AARC clinical practice guideline: Effectiveness of pharmacologic airway clearance therapies in hospitalized patients","volume":"60","author":"Strickland SL","year":"2015","journal-title":"Respir Care"}],"container-title":["Revista Paulista de Pediatria"],"original-title":[],"deposited":{"date-parts":[[2023,1,8]],"date-time":"2023-01-08T11:53:41Z","timestamp":1673178821000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0103-05822022000100604&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":16,"alternative-id":["S0103-05822022000100604"],"URL":"https:\/\/doi.org\/10.1590\/1984-0462\/2022\/40\/2020169","relation":{},"ISSN":["1984-0462","0103-0582"],"issn-type":[{"type":"electronic","value":"1984-0462"},{"type":"print","value":"0103-0582"}],"subject":[],"published":{"date-parts":[[2022]]},"article-number":"e2020169"}}