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Bronchoscopic interventions with surfactant and recombinant human deoxyribonuclease for acute respiratory distress syndrome–type respiratory syncytial virus–pneumonia in moderately preterm infants: Case series

Atelectases, over-inflation of ventilated regions of the lung, and consecutive pneumothoraces are life-threatening conditions in mechanically ventilated infants with acute respiratory distress syndrome–type respiratory syncytial virus–pneumonia. The accumulation of viscous secretions secondary to im...

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Detalles Bibliográficos
Autores principales: Krause, Martin F, Ankermann, Tobias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857361/
https://www.ncbi.nlm.nih.gov/pubmed/27489660
http://dx.doi.org/10.1177/2050313X14554479
Descripción
Sumario:Atelectases, over-inflation of ventilated regions of the lung, and consecutive pneumothoraces are life-threatening conditions in mechanically ventilated infants with acute respiratory distress syndrome–type respiratory syncytial virus–pneumonia. The accumulation of viscous secretions secondary to impaired mucociliary clearance in the more proximal parts of the bronchial tree is the prerequisite for atelectases and also prevents the delivery of inhaled medications to the more distal parts of the lung. Herein, we describe four moderately premature infants with respiratory failure on mechanical ventilation, displaying a total of 20 radiologically verified new atelectases that were treated by bronchoscopic interventions with consecutive suctioning of secretions, restoration of the surfactant film within the airways, and deposition of recombinant human deoxyribonuclease at the first segment level of the bronchial tree. On 13 occasions (65%), resolution of atelectases was proven by chest X-ray and resulted in improved lung function. We conclude that these bronchoscopic interventions may contribute to the restoration of the gas exchange area in moderately premature infants with acute respiratory distress syndrome–type respiratory syncytial virus–pneumonia.