Recombinant human deoxyribonuclease shortens ventilation time in young, mechanically ventilated children

Joachim Riethmueller*, Thomas Borth-Bruhns, Matthias Kumpf, Reinhard Vonthein, Jakub Wiskirchen, Martin Stern, Michael Hofbeck, Winfried Baden

*Corresponding author for this work
49 Citations (Scopus)


Recombinant human deoxyribonuclease I (dornase alfa) is currently used as an inhaled mucoactive agent in the treatment of cystic fibrosis. In a randomized, placebo-controlled, double-blind clinical study in 100 infants, we investigated whether the therapeutic use of dornase alfa can be extended to ventilated, fluid-restricted children to reduce reintubation rate, ventilation duration, pediatric intensive care unit (PICU) stay, and ventilation complications. While reintubation rates were similar for dornase alfa 7% vs. placebo 9% (odds ratio, 0.77; confidence interval, 0.11-4.9), the incidence of atelectasis (6 vs. 17, respectively; P-value 0.051), median ventilation time (2.2 vs. 3.4 days, respectively; P-value 0.043), median length of PICU stay (7 vs. 8 days, respectively; P-value 0.051), and mean costs (€4,830 vs. €6,320, respectively) were lower in the dornase alfa group. No adverse effects were observed, even in critically ill patients. We found that dornase alfa was beneficial and safe. Our findings also indicate that dornase alfa is possibly of value from the first day of mechanical ventilation onward, particularly when longer ventilation (>3 days) is expected in fluid-restricted children after cardiac surgery.

Original languageEnglish
JournalPediatric Pulmonology
Issue number1
Pages (from-to)61-66
Number of pages6
Publication statusPublished - 01.2006


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