HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (23) Citing Articles via Google Scholar Google Scholar Articles by Nasr, S. Z. Articles by Moler, F. W. Search for Related Content PubMed PubMed Citation Articles by Nasr, S. Z. Articles by Moler, F. W.

Efficacy of Recombinant Human Deoxyribonuclease I in the Hospital Management of Respiratory Syncytial Virus Bronchiolitis^*

^* From the Divisions of Pediatric Pulmonology (Drs. Nasr and Maxvold), Radiology (Dr. Strouse), and Critical Care (Dr. Moler), University of Michigan Health System, Ann Arbor, MI; the Departments of Pediatrics (Dr. Soskolne) and Radiology (Dr. Garver), St. Joseph Mercy Hospital, Ann Arbor, MI; and Department of Pediatrics, Medicine, Physiology, and Pharmacology (Dr. Rubin), Wake Forest University School of Medicine, Winston-Salem, NC.

Correspondence to: Samya Z. Nasr, MD, Department of Pediatrics, University of Michigan Medical Center, 1500 E. Medical Center Dr, Ann Arbor, MI 48109-0212

Objective: To evaluate the effect of recombinant human deoxyribonuclease I (rhDNase) in shortening the length of the hospitalization and improving the chest radiographs (CXRs) in hospitalized infants with respiratory syncytial virus (RSV) infection as a result of its mucolytic properties.

Methods: Randomized, double-blind, placebo-controlled investigation of 75 patients with RSV bronchiolitis. The study was conducted at the University of Michigan Medical Center and St. Joseph Mercy Hospital, both in Ann Arbor, MI.

Results: The respiratory rate, wheezing, and retraction difference scores, obtained by subtracting the hospital discharge score from the corresponding hospital admission score, show no difference between the two groups, but the CXR difference scores show that the rhDNase group improved by 0.46 while the placebo group worsened by 0.60 (p < 0.001). Analysis of covariance for the hospital discharge CXR score after adjusting for the hospital admission score for both groups was done. There was a difference in scores between the two groups, with adjusted mean for the study group of 2.03, and 2.76 for the placebo group (p < 0.001). Paired t test statistics in each of the two groups were computed. For the placebo group, the mean increase of 0.60 was significant (p = 0.02), and the mean decrease of 0.46 for the rhDNase group was also significant (p = 0.02). A one-way analysis of covariance with the hospital discharge CXR scores as the dependent variable and the hospital admission score as the covariate showed that there was a significant difference between the groups (p = 0.01).

Conclusion: In patients with RSV bronchiolitis, there was significant improvement in the CXRs with the use of rhDNase compared to significant worsening in the placebo group. To our knowledge, this is the first report of the use of rhDNase to treat RSV bronchiolitis.

Key Words: chest radiography • clinical score • length of stay • mucus • randomized clinical trial • respiratory syncytial virus

This article has been cited by other articles:

				R. Boogaard, A. R. Hulsmann, L. van Veen, A. A. P. H. Vaessen-Verberne, Y. N. Yap, A. J. Sprij, G. Brinkhorst, B. Sibbles, T. Hendriks, S. W. W. Feith, et al. Recombinant Human Deoxyribonuclease in Infants With Respiratory Syncytial Virus Bronchiolitis Chest, March 1, 2007; 131(3): 788 - 795. [Abstract] [Full Text] [PDF]

				W. C. Bordley, M. Viswanathan, V. J. King, S. F. Sutton, A. M. Jackman, L. Sterling, and K. N. Lohr Diagnosis and Testing in Bronchiolitis: A Systematic Review Arch Pediatr Adolesc Med, February 1, 2004; 158(2): 119 - 126. [Abstract] [Full Text] [PDF]

				V. J. King, M. Viswanathan, W. C. Bordley, A. M. Jackman, S. F. Sutton, K. N. Lohr, and T. S. Carey Pharmacologic Treatment of Bronchiolitis in Infants and Children: A Systematic Review Arch Pediatr Adolesc Med, February 1, 2004; 158(2): 127 - 137. [Abstract] [Full Text] [PDF]

				C. A. McCarthy and C. B. Hall Respiratory Syncytial Virus: Concerns and Control Pediatr. Rev., September 1, 2003; 24(9): 301 - 309. [Full Text] [PDF]

				A. Mandelberg, G. Tal, M. Witzling, E. Someck, S. Houri, A. Balin, and I. E. Priel Nebulized 3% Hypertonic Saline Solution Treatment in Hospitalized Infants With Viral Bronchiolitis Chest, February 1, 2003; 123(2): 481 - 487. [Abstract] [Full Text] [PDF]

				E. M. Sarrell, G. Tal, M. Witzling, E. Someck, S. Houri, H. A. Cohen, and A. Mandelberg Nebulized 3% Hypertonic Saline Solution Treatment in Ambulatory Children With Viral Bronchiolitis Decreases Symptoms Chest, December 1, 2002; 122(6): 2015 - 2020. [Abstract] [Full Text] [PDF]