Nasal trauma due to continuous positive airway pressure in neonates.
Détails
ID Serval
serval:BIB_48DD29E6F1F0
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Nasal trauma due to continuous positive airway pressure in neonates.
Périodique
Archives of Disease In Childhood. Fetal and Neonatal Edition
ISSN
1468-2052[electronic], 1359-2998[linking]
Statut éditorial
Publié
Date de publication
2010
Volume
95
Numéro
6
Pages
F447-F451
Langue
anglais
Notes
Publication types: Journal Article
Résumé
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.
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.
Mots-clé
Birth Weight, Continuous Positive Airway Pressure/adverse effects, Continuous Positive Airway Pressure/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
Pubmed
Web of science
Création de la notice
15/02/2011 11:15
Dernière modification de la notice
20/08/2019 13:55
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