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[Septum necrosis following CPAP treatment of preterm infant]

Alexander Fjaeldstad1, Rasa Cipliene, Trine Ramsgaard-Jensen

  • 1Pædiatrisk Afdeling, Afsnit Nord, Aalborg Universitetshospital, postboks 561, 9100 Aalborg N. alefja@rm.dk.

Ugeskrift for Laeger
|August 7, 2014
PubMed

Insights

Nasal continuous positive airway pressure (CPAP) can cause nasal septum necrosis in preterm infants. Careful monitoring and appropriate device selection are crucial to prevent these severe complications during respiratory support.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Critical Care

Background:

  • Preterm infants often require prolonged respiratory support, increasing the risk of complications.
  • Nasal continuous positive airway pressure (CPAP) is a common non-invasive ventilation method for neonates.
  • Different CPAP delivery interfaces, such as prongs and masks, may have varying associated risks.

Observation:

  • A case of nasal septum necrosis developed in a preterm infant undergoing two months of intensive nasal CPAP therapy.
  • The infant experienced intermittent use of both CPAP-mask and CPAP-prongs.
  • An ulcer in the nasal mucus membrane preceded the development of septum necrosis.

Findings:

  • Continuous positive airway pressure (CPAP) therapy, while essential, can lead to significant nasal trauma.
  • Nasal septum necrosis is a severe complication that can arise from prolonged or improperly managed CPAP use.
  • Binasal CPAP-prongs have demonstrated greater efficacy compared to mononasal therapy.

Implications:

  • Healthcare providers must be vigilant about potential nasal complications associated with CPAP in preterm infants.
  • Choosing the appropriate CPAP interface and monitoring for early signs of injury are critical for patient safety.
  • Further research into optimizing CPAP delivery methods to minimize mucosal damage is warranted.

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