Atelectasis during mechanical ventilation.
Conditions
Interventions
Intervention group: Twice daily: inhaled rhDNase, 2.5 ml and twice daily 4 ml isotonic saline (NaCl 0.9%), for two days.
Control group: Twice daily: inhaled isotinic saline 2.5 ml and twice daily 4 m
Sponsors
Erasmus Medical Center, Sophia Children's Hospital. Dr. Molewaterplein 60,
3015 GJ Rotterdam
Eligibility
Inclusion criteria
Inclusion criteria: 1. Age 0-18 years; 2. Mechanical ventilation; 3. Presence of an atelectasis on a chest radiograph; 4. First dose of study medication can be administered preferably within 6 hours (max 12 hours) after an atelectasis has been diagnosed.
Exclusion criteria
Exclusion criteria: 1. Children with neuromuscular disorders and impaired ability to cough; cardiomyopathy; or cystic fibrosis; 2. Post-gestational age < 32 weeks; 3. Mechanical ventilation during muscle paralysis; 4. Atelectasis due to a bronchoscopically diagnosed: - foreign body aspiration; - tracheal or bronchial compression by lymph nodes or vessels; 5. Recurrent atelectasis due to an anatomical airway-abnormality; 6. RhDNase treatment in the previous 48 hours; 7. Clinical condition or ventilator settings that are not compatible with nebulizing medication (according to the responsible physician); 8. Presence of a pneumothorax; 9. Previous participation in the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in a Chest radiograph-score (CXR-score) at 48 hours. | — |
Secondary
| Measure | Time frame |
|---|---|
| Change in a Chest radiograph-score at 24 hours, and change in: ventilatory settings; saturation; blood-gas values; DNA content and cytokines in tracheal aspirates; duration of mechanical ventilation; length of stay. | — |
Contacts
Public ContactR. Boogaard
Erasmus Medical Center, Sophia Children’s Hospital, Department of Pediatric Pulmonology, SB-2666, P.O. Box 2060
Outcome results
None listed