Bronchoscopically administered recombinant human DNase for lobar atelectasis in cystic fibrosis

Pediatr Pulmonol. 2001 May;31(5):383-8. doi: 10.1002/ppul.1062.


Lobar atelectasis is a common complication of cystic fibrosis. The majority of cases respond to intravenous antibiotics and chest physiotherapy. In a subgroup of patients, atelectasis is resistant to medical therapy, and its persistence in the pediatric population is associated with a poor prognosis. Bronchoscopic instillation of human recombinant DNase expanded atelectatic lobes in three children resistant to at least 2 weeks of medical therapy. This method of administration of DNase has been successful in resistant cases of lobar atelectasis in patients with chronic obstructive pulmonary disease, quadriplegia, and status asthmaticus. Purulent cystic fibrosis sputum has a very high DNA content, and DNA has been shown to become more pourable in vitro when treated with rhDNase. Bronchoscopic instillation of rhDNase should be considered in cases of persistent lobar atelectasis unresponsive to medical therapy.

Publication types

  • Case Reports

MeSH terms

  • Bronchoscopy*
  • Child
  • Cystic Fibrosis / complications*
  • Cystic Fibrosis / diagnostic imaging
  • Deoxyribonuclease I / administration & dosage*
  • Deoxyribonuclease I / therapeutic use*
  • Expectorants / administration & dosage*
  • Expectorants / therapeutic use*
  • Female
  • Humans
  • Instillation, Drug
  • Pulmonary Atelectasis / diagnostic imaging
  • Pulmonary Atelectasis / drug therapy*
  • Pulmonary Atelectasis / etiology*
  • Radiography
  • Recombinant Proteins / administration & dosage*
  • Recombinant Proteins / therapeutic use*


  • Expectorants
  • Recombinant Proteins
  • DNASE1 protein, human
  • Deoxyribonuclease I