| Nasal trauma due to continuous positive airway pressure in neonates. | |
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MedLine Citation:
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PMID: 20584802 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Céline Fischer; Valérie Bertelle; Judith Hohlfeld; Margot Forcada-Guex; Corinne Stadelmann-Diaw; Jean-François Tolsa |
Publication Detail:
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Type: Journal Article Date: 2010-06-28 |
Journal Detail:
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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:
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Created Date: 2010-10-27 Completed Date: 2010-12-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9501297 Medline TA: Arch Dis Child Fetal Neonatal Ed Country: England |
Other Details:
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Languages: eng Pagination: F447-51 Citation Subset: AIM; IM |
Affiliation:
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Division of Neonatology, Department of Paediatrics, Centre Hospitalier University Hospital of Lausanne, Lausanne, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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 |
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