Document Detail


Nasal trauma due to continuous positive airway pressure in neonates.
MedLine Citation:
PMID:  20584802     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the incidence and severity of nasal trauma secondary to nasal continuous positive airway pressure (nCPAP) in neonates.
DESIGN: Prospective observational study.
SETTING: Neonatal intensive care unit (NICU) of the University Hospital of Lausanne, Switzerland.
PATIENTS: All neonates admitted between January 2002 and December 2007 treated by nCPAP were eligible.
METHODS: Patients' noses were monitored during nCPAP. Nasal trauma was reported into three stages: (I) persistent erythema; (II) superficial ulceration; and (III) necrosis.
RESULTS: 989 neonates were enrolled. Mean gestational age was 34 weeks (SD 4), mean birth weight 2142 g (SD 840). Nasal trauma was reported in 420 (42.5%) patients and it was of stage I, II and III in 371 (88.3%), 46 (11%) and 3 (0.7%) patients, respectively. Incidence and severity of trauma were inversely correlated with gestational age and birth weight. The risk of nasal trauma was greater in neonates <32 weeks of gestational age (OR 2.48, 95% CI 1.59 to 3.86), weighing <1500 g at birth (OR 2.28, 95% CI 1.43 to 3.64), treated >5 days by nCPAP (OR 5.36, 95% CI 3.82 to 7.52), or staying >14 days in the NICU (OR 1.67, 95% CI 1.22 to 2.28). Most cases of nasal trauma (90%) appeared during the first 6 days of nCPAP. Persistent visible scars were present in two cases.
CONCLUSIONS: Nasal trauma is a frequent complication of nCPAP, especially in preterm neonates, but long-term cosmetic sequelae are very rare. This study provides a description of nasal trauma and proposes a simple staging system. This could serve as a basis to develop strategies of prevention and treatment of this iatrogenic event.
Authors:
Céline Fischer; Valérie Bertelle; Judith Hohlfeld; Margot Forcada-Guex; Corinne Stadelmann-Diaw; Jean-François Tolsa
Publication Detail:
Type:  Journal Article     Date:  2010-06-28
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  95     ISSN:  1468-2052     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-27     Completed Date:  2010-12-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F447-51     Citation Subset:  AIM; IM    
Affiliation:
Division of Neonatology, Department of Paediatrics, Centre Hospitalier University Hospital of Lausanne, Lausanne, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Birth Weight
Continuous Positive Airway Pressure / adverse effects*,  methods
Erythema / etiology
Female
Gestational Age
Humans
Infant, Newborn
Infant, Premature
Intensive Care, Neonatal / methods
Male
Necrosis
Nose / injuries*
Nose Diseases / etiology
Prospective Studies
Trauma Severity Indices
Ulcer / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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