# Persistent Atelectasis Prevalence and Incidence in Pediatric Critical Care

## TL;DR

This study examines how common persistent atelectasis is in critically ill children and finds that dornase treatment may help reduce new cases.

## Contribution

The study provides new prevalence and incidence data for persistent atelectasis in pediatric critical care and evaluates the impact of dornase treatment.

## Key findings

- Dornase-treated patients had a 48.18% prevalence of persistent atelectasis compared to 51.82% in the non-dornase group.
- The incidence of new at-risk cases was significantly lower in the dornase group (26.4) than in the non-dornase group (71.5).
- Dornase treatment showed potential to prevent atelectasis progression in pediatric patients.

## Abstract

Background and objective

In critical care, persistent atelectasis worries pediatricians. The research on hospitalized pediatric patients with persistent atelectasis reports limited data about prevalence and incidence. The study aimed to determine the prevalence and incidence of persistent atelectasis in pediatrics.

Methodology and materials

This retrospective observational study was carried out in the pediatric intensive care unit (PICU) of King Fahad Medical City (KFMC) between February 2020 and October 2023. Pediatric patients with pulmonary atelectasis for more than 48 hours. Patients who were admitted to the PICU were taken into the study and evaluated after taking informed consent. Patients who were prescribed dornase alfa for atelectasis treatment. The prevalence and incidence of the disease were calculated in both treatment groups; independent t-tests and chi-square tests were used to compare continuous and categorical variables, respectively, between the dornase and non-dornase groups. Correlation analysis was performed using Pearson’s correlation coefficient to examine relationships between clinical parameters. Regression analysis was conducted to identify significant predictors of intensive care unit (ICU) length of stay and persistent atelectasis, with model significance evaluated using the F-statistic and R² values. A p-value < 0.05 was considered statistically significant for all analyses.

Results

The prevalence of persistent atelectasis reached 48.18% among patients who received dornase, while the non-dornase group experienced 51.82% atelectasis occurrence. The incidence analysis demonstrated a major distinction between groups where dornase-treated patients experienced 26.4 new at-risk patient cases but non-dornase-treated patients developed 71.5 new cases.

Conclusion

The dornase treatment group demonstrates the potential to decrease new persistent atelectasis incidence in pediatric critical care units. The non-dornase group showed slightly higher persistent atelectasis prevalence and incidence rates yet dornase treatment seemed to prevent atelectasis progression in pediatric patients at risk. The research demonstrates dornase's ability to prevent atelectasis occurrence yet its effect on patient overall survival remained concerning because of the retrospective study design. Future researchers are encouraged to do studies that help to establish a causal relationship between dornase alfa and persistent atelectasis occurrence.