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Protective Dressings, Injury, and Device Failure in Preterm Infants Receiving Nasal Continuous Positive Airway
Parvane Rezaei1, Soheila Jafari-Mianaei, Alireza Sadeghnia
1At the Isfahan University of Medical Sciences, Iran, Parvane Rezaei, MS, is a nursing student, Faculty of Nursing and Midwifery; Soheila Jafari-Mianaei, PhD, is Assistant Professor, Department of Pediatric and Neonatal Nursing; Alireza Sadeghnia, MD, is Associate Professor, Department of Pediatrics; and Zahra Heidari, PhD, is Assistant Professor, Department of Biostatistics and Epidemiology. Acknowledgments: The authors thank the Isfahan University of Medical Sciences, the staff of the neonatal ICU wards of Shahid Beheshti and Al-Zahra Hospitals of Isfahan, and the tiny infants who participated in this study. This study originated from a master's thesis supported financially with a grant from the Isfahan University of Medical Sciences. The authors have disclosed no other financial relationships related to this article. Submitted September 22, 2020; accepted in revised form November 5, 2020.
Insights
A hydrocolloid nasal dressing significantly reduced nasal injury incidence and severity in preterm infants receiving nasal continuous positive airway pressure (N-CPAP). The dressing did not affect N-CPAP failure rates.
Area of Science:
- Neonatal care
- Medical device technology
- Clinical research
Background:
- Preterm infants often require nasal continuous positive airway pressure (N-CPAP) for respiratory support.
- Nasal injury is a common complication associated with N-CPAP use in neonates.
- Preventive strategies are crucial to minimize adverse effects during N-CPAP therapy.
Purpose of the Study:
- To evaluate the efficacy of a hydrocolloid nasal dressing in preventing nasal injury.
- To assess the impact of the dressing on the severity of nasal injury.
- To determine if the dressing affects the rate of N-CPAP failure in preterm infants.
Main Methods:
- A randomized controlled trial involving 80 preterm infants (gestational age ≤32 weeks or birth weight ≤1,500 g) receiving N-CPAP.
- Infants were assigned to either a group using a protective hydrocolloid nasal dressing or a control group receiving routine care.
- Data on nasal injury incidence, severity, and N-CPAP failure were collected and analyzed.
Main Results:
- The incidence of nasal injury was significantly lower in the intervention group (37.5%) compared to the control group (92.5%; P < .001).
- The severity of nasal injuries was also reduced in infants using the dressing.
- No significant difference in N-CPAP failure rates was observed between the two groups (P > .05).
Conclusions:
- A hydrocolloid nasal barrier dressing is effective in reducing the incidence and severity of nasal injury in preterm infants undergoing N-CPAP.
- The dressing is a safe and practical intervention for neonatal intensive care units.
- Further research may explore long-term outcomes and broader applications.
Objective:
To investigate the protective effect of a hydrocolloid nasal dressing on the incidence and severity of nasal injury and continuous positive airway pressure (CPAP) failure in preterm infants receiving nasal CPAP (N-CPAP).
Methods:
A randomized controlled trial was conducted over 4 months in 2019 at level 3 neonatal ICUs in two hospitals affiliated with Isfahan University of Medical Sciences, Iran. Eighty eligible infants were born at 32 weeks of gestation or younger and/or with a birth weight of 1,500 g or less and had received between 4 and 72 hours of CPAP. Infants were randomly assigned to two groups; the intervention group used a protective dressing, and the control group received routine care. Data collection tools included a demographic questionnaire and nasal injury assessment score chart.
Main Outcome Measures:
The incidence and severity of nasal injury in preterm infants undergoing N-CPAP.
Results:
Infants in the intervention group had a significantly lower incidence and severity of nasal injury compared with the control group: 15 of 40 (37.5%) versus 37 of 40 (92.5%; P < .001). Overall, the injuries identified in this study were mostly mild and moderate, with only three severe injuries in the intervention group and five in the control group. No significant differences were detected in CPAP failure (P > .05).
Conclusions:
The studied nasal barrier dressing is a safe and convenient solution to reduce nasal injury in preterm infants receiving N-CPAP.
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