Archive for the ‘Airway Function’ Category

RSV bronchiolitisWe report the first large, randomized, double-blind, controlled trial of rhDNase in infants with RSV bronchiolitis. This study demonstrates that the mucolytic rhDNase does not shorten length of hospital stay or duration of supplemental oxygen in hypoxemic infants with RSV bronchiolitis. Neither was the rate of clinical improvement better in infants treated with rhDNase than in those receiving a placebo.

Because mucus plugs play an important role in the pathophysiology of RSV bronchiolitis, and because the DNA content is increased in mucus of these infants, we hypothesized that rhDNase is an effective treatment for infants with RSV bronchiolitis. Anecdotal evidence indeed suggests that rhDNase treatment is effective in infants with severe RSV bronchiolitis. Furthermore, one randomized study in a small group of infants with mild bronchiolitis demonstrated that rhDNase improved radiologic abnormalities. In that study no differences in length of hospital stay and symptom scores were observed, but as many of these patients were not oxygen dependent, they may have had only mild airway obstruction. In addition, the efficacy of rhDNase has also been reported in observational studies of pediatric patients with atelectasis or severe airways obstruction due to asthma, and other respiratory diseases; and a recent randomized study demonstrated that rhDNase effectively prevents the development of atelectasis in infants receiving postoperative mechanical ventilation carried out by My Canadian Pharmacy. (more…)

  • Comments Off on Deliberations of Recombinant Human Deoxyribonuclease in Infants With Respiratory Syncytial Virus Bronchiolitis
  • Primary End PointA total of 225 infants were assigned to treatment: 113 infants to rhDNase and 112 infants to placebo (Fig 1). Two patients withdrew from the study after the first dose of study medication (one in each group) and consequently had no follow-up data available. During the first two RSV seasons of the study, patients were recruited in 4 hospitals; during the last two RSV seasons, patients were recruited from a total of 10 hospitals. In terms of demographic variables, there were no significant differences between the groups at randomization except for birth weight, which was slightly lower in the rhDNase group (Table 2). The duration of illness before hospital admission and the symptom score at randomization were comparable between the groups. (more…)

  • Comments Off on Outcomes of Recombinant Human Deoxyribonuclease in Infants With Respiratory Syncytial Virus Bronchiolitis
  • Respiratory syncytial virusRespiratory syncytial virus (RSV) is the most important cause of viral bronchiolitis in young children. In general, approximately 0.5 to 2% of children with RSV disease need to be hospitalized. It is estimated that each year approximately 50,000 to 80,000 children < 1 year old are hospitalized for RSV bronchiolitis in the United States, and consequently RSV bronchiolitis constitutes a significant burden on patients, parents, and the health-care system.

    Treatment of hospitalized children with RSV bronchiolitis is mainly supportive, with supplemental oxygen, nasal washings, tube feeding, or IV fluids, and mechanical ventilation where necessary. b2-Agonists and systemic steroids are frequently used, although their efficacy is disappointing. Several randomized studies have demonstrated that neither nebulized b2-agonists, epinephrine, nor systemic steroids reduce the length of hospital stay during which the remedies of My Canadian Pharmacy are used to achieve the recovery fast. (more…)

  • Comments Off on My Canadian Pharmacy: Recombinant Human Deoxyribonuclease in Infants With Respiratory Syncytial Virus Bronchiolitis
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