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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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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
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author Krause, Martin F
Ankermann, Tobias
author_facet Krause, Martin F
Ankermann, Tobias
author_sort Krause, Martin F
collection PubMed
description 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.
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spelling pubmed-48573612016-08-03 Bronchoscopic interventions with surfactant and recombinant human deoxyribonuclease for acute respiratory distress syndrome–type respiratory syncytial virus–pneumonia in moderately preterm infants: Case series Krause, Martin F Ankermann, Tobias SAGE Open Med Case Rep Case Report 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. SAGE Publications 2014-10-08 /pmc/articles/PMC4857361/ /pubmed/27489660 http://dx.doi.org/10.1177/2050313X14554479 Text en © The Author(s) 2014 http://creativecommons.org/licenses/by-nc/3.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(http://www.uk.sagepub.com/aboutus/openaccess.htm).
spellingShingle Case Report
Krause, Martin F
Ankermann, Tobias
Bronchoscopic interventions with surfactant and recombinant human deoxyribonuclease for acute respiratory distress syndrome–type respiratory syncytial virus–pneumonia in moderately preterm infants: Case series
title Bronchoscopic interventions with surfactant and recombinant human deoxyribonuclease for acute respiratory distress syndrome–type respiratory syncytial virus–pneumonia in moderately preterm infants: Case series
title_full Bronchoscopic interventions with surfactant and recombinant human deoxyribonuclease for acute respiratory distress syndrome–type respiratory syncytial virus–pneumonia in moderately preterm infants: Case series
title_fullStr Bronchoscopic interventions with surfactant and recombinant human deoxyribonuclease for acute respiratory distress syndrome–type respiratory syncytial virus–pneumonia in moderately preterm infants: Case series
title_full_unstemmed Bronchoscopic interventions with surfactant and recombinant human deoxyribonuclease for acute respiratory distress syndrome–type respiratory syncytial virus–pneumonia in moderately preterm infants: Case series
title_short Bronchoscopic interventions with surfactant and recombinant human deoxyribonuclease for acute respiratory distress syndrome–type respiratory syncytial virus–pneumonia in moderately preterm infants: Case series
title_sort bronchoscopic interventions with surfactant and recombinant human deoxyribonuclease for acute respiratory distress syndrome–type respiratory syncytial virus–pneumonia in moderately preterm infants: case series
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857361/
https://www.ncbi.nlm.nih.gov/pubmed/27489660
http://dx.doi.org/10.1177/2050313X14554479
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