Endotracheal N-acetylcysteine for atelectasis in neonatal pneumonia

Although there is no gold standard therapy in the treatment of atelectasis in newborns, surfactant therapy, inhaled mucolytic agents, recombinant human DNase, positive pressure mechanical ventilation, postural changes and drainage can be used. However, N-acetylcysteine, via endo-bronchoscopy, is rarely used to break the disulfide bonds in the mucus. It is cheap and easily available to apply for treatment. Here we presented a newborn with neonatal pneumonia to whom we instilled N-acetylcysteine thorough endotracheal tube to resolve the right lung total atelectasis. The atelectasis responded to instillation quickly and successfully. We are presenting the case in order to suggest a novel effective treatment modality for already intubated newborns with atelectasis. This case also represents the treatment of first successful case in newborn period.