Tian Dai1,2,3,4,5,6, Limin Lv1,2,3,4,5,6, Xiaojuan Liu1,2,3,4,5,6, Jin Chen1,2,3,4,5,6, Yalan Ye1,2,3,4,5,6, Lixuan Xu1,2,3,4,5,6. 1. Tian Dai, MD, RN, Department of Neonatal Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, China. 2. Limin Lv, MD, RN, Department of Neonatal Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, China. 3. Xiaojuan Liu, BD, RN, Department of Neonatal Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, China. 4. Jin Chen, BD, RN, Department of Neonatal Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, China. 5. Yalan Ye, BD, RN, Department of Neonatal Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, China. 6. Lixuan Xu, BD, RN, Department of Neonatal Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, China.
Abstract
PURPOSE: The purpose of this study was to calculate incidence, severity, and risk factors of nasal pressure injuries due to nasal continuous positive airway pressure (NCPAP) treatment in newborns. DESIGN: A prospective observational study. SUBJECTS AND SETTING: Newborns admitted between March 2017 and February 2018 to the neonatal intensive care unit of the First Affiliated Hospital of Xiamen University, Xiamen, China. METHODS: All newborns' noses were examined during NCPAP application. Every NCPAP-related nasal pressure injury including occurrence date, injury severity, outcomes, and pressure injury treatment methods was recorded. These data were collected twice a week by a research nurse. Nasal pressure injuries were classified using the National Pressure Ulcer Advisory Panel/European Pressure Ulcer Advisory Panel pressure injury classification system. RESULTS: During the study period, 429 newborns received NCPAP treatment via nasal prongs. Nasal pressure injuries were observed in 149 (34.7%); 99 (66.44%) were classified as Stage 1, 48 (32.31%) were Stage 2, and 2 (1.25%) cases were classified as deep tissue injury. The risk of nasal pressure injury was significantly higher when gestational age was less than 32 weeks (odds ratio [OR], 3.728; 95% confidence interval [CI], 1.18-11.77; P ≤ .025) and in those who received NCPAP treatment for more than 6 days (OR, 0.262; 95% CI, 0.087-0.787; P ≤ .017). The mean interval between the application of NCPAP and onset of nasal pressure injury was 4.72 days (SD, 4.78; range, 0-30 days). CONCLUSIONS: Nasal pressure injuries are a prevalent complication of NCPAP use, especially in preterm newborns. Our results identified a gestational age of less than 32 weeks and longer use of NCPAP are important factors associated with nasal pressure injuries. Methods to prevent the development of injuries such as the use of a prophylactic dressing along and replacement of binasal prongs with nasal masks are advocated.
PURPOSE: The purpose of this study was to calculate incidence, severity, and risk factors of nasal pressure injuries due to nasal continuous positive airway pressure (NCPAP) treatment in newborns. DESIGN: A prospective observational study. SUBJECTS AND SETTING: Newborns admitted between March 2017 and February 2018 to the neonatal intensive care unit of the First Affiliated Hospital of Xiamen University, Xiamen, China. METHODS: All newborns' noses were examined during NCPAP application. Every NCPAP-related nasal pressure injury including occurrence date, injury severity, outcomes, and pressure injury treatment methods was recorded. These data were collected twice a week by a research nurse. Nasal pressure injuries were classified using the National Pressure Ulcer Advisory Panel/European Pressure Ulcer Advisory Panel pressure injury classification system. RESULTS: During the study period, 429 newborns received NCPAP treatment via nasal prongs. Nasal pressure injuries were observed in 149 (34.7%); 99 (66.44%) were classified as Stage 1, 48 (32.31%) were Stage 2, and 2 (1.25%) cases were classified as deep tissue injury. The risk of nasal pressure injury was significantly higher when gestational age was less than 32 weeks (odds ratio [OR], 3.728; 95% confidence interval [CI], 1.18-11.77; P ≤ .025) and in those who received NCPAP treatment for more than 6 days (OR, 0.262; 95% CI, 0.087-0.787; P ≤ .017). The mean interval between the application of NCPAP and onset of nasal pressure injury was 4.72 days (SD, 4.78; range, 0-30 days). CONCLUSIONS: Nasal pressure injuries are a prevalent complication of NCPAP use, especially in preterm newborns. Our results identified a gestational age of less than 32 weeks and longer use of NCPAP are important factors associated with nasal pressure injuries. Methods to prevent the development of injuries such as the use of a prophylactic dressing along and replacement of binasal prongs with nasal masks are advocated.
Authors: Paulo André Freire Magalhães; Ana Carolina Gusmão D'Amorim; Elis Fernanda Araújo Lima de Oliveira; Maria Evelyne Albuquerque Ramos; Ana Patrícia Duarte de Aquino Mendes; Juliana Fernandes de Souza Barbosa; Cyda Maria Albuquerque Reinaux Journal: Rev Bras Ter Intensiva Date: 2022 Apr-Jun