- Poster presentation
- Open Access
Safety and efficacy of intratracheal DNase with physiotherapy in severe status asthmaticus
© Nyman et al. 2011
- Published: 1 March 2011
- Extracorporeal Membrane Oxygenation
- Airflow Limitation
- Peak Inspiratory Pressure
- Status Asthmaticus
Diffuse airway plugging with thick viscous secretions is recognised in acute severe asthma, and contributes to airflow limitation in ventilated asthmaticus. Since 2004, we have used intratracheal DNase with physiotherapy as second-line therapy in mechanically ventilated children with severe status asthmatics who are refractory to conventional medical management. Our aim is to report the safety profile and efficacy of intratracheal DNase mucolytic therapy in this cohort.
A retrospective cohort analysis in a 20-bed PICU. Forty-six ventilated children, median (IQR) age 74 months (45 to 141), received intratracheal DNase with physiotherapy (January 2004 to August 2010). Indication for DNase was peak inspiratory pressure (PIP) >28 cmH2O with hypercarbic acidosis (pCO2 > 10 kPa). Eleven patients required additional doses of DNase. In 40 episodes DNase was given blindly (n = 40) or bronchoscopically (n = 17).
Intratracheal DNase with physiotherapy is safe and effective therapy for refractory ventilated patients with status asthmatics. A randomised control trial is warranted.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.