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Published on: July 14, 2023
French Neonatal Society issues recommendations on preventing nasal injuries in preterm newborn infants during
Claire Zores1,2, Elodie Zana-Taïeb3,4, Laurence Caeymaex5,6
1Médecine et Réanimation du Nouveau - né, Service de Pédiatrie 2, Pôle Medico - Chirurgical Pédiatrique Hôpital de Hautepierre, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France.
Insights
Nasal skin injuries are common in preterm infants receiving non-invasive ventilation. Using hydrocolloids, masks, and rotating interfaces can effectively prevent these lesions.
Area of Science:
- Neonatal care
- Dermatology
- Respiratory support
Background:
- Non-invasive ventilation (NIV) is crucial for preterm infants.
- Nasal skin integrity is a significant concern during NIV.
- Preterm infants have fragile skin, increasing susceptibility to injury.
Purpose of the Study:
- To provide evidence-based recommendations for optimal nasal skin care during NIV.
- To identify risk factors and preventive strategies for nasal injuries in neonates.
Main Methods:
- Systematic literature search of PubMed (up to December 2019).
- Inclusion of English and French studies.
- Evaluation of evidence grades for identified studies.
Main Results:
- Forty-eight studies were included, showing a high incidence of nasal injuries in preterm infants.
- Injuries were more common in infants <30 weeks gestational age and <1500g.
- Effective prevention strategies include hydrocolloids, mask use, and interface rotation.
Conclusions:
- Nasal injuries from continuous positive airway pressure (CPAP) are frequent in preterm newborns.
- These injuries can cause pain, discomfort, and long-term effects.
- Specific caregiver attention and parental awareness are vital for protecting immature neonatal skin.
Aim:
To issue practical recommendations regarding the optimal care of nasal skin when non-invasive ventilation support is used.
Methods:
We performed a systematic search of PubMed to identify relevant papers published in English or French through December 2019. Different grades of evidence were evaluated.
Results:
Forty-eight eligible studies. The incidence in preterm infants was high. The lesions were more frequent for preterm infants born under 30 weeks of gestational age and/or below 1500 g. The lesion was most often located on the skin of the nose but could also be found on the intranasal mucous membranes or elsewhere on the face. Nasal injuries appear early after the beginning of non-invasive ventilation at a mean of 2-3 days for cutaneous lesions and eight or nine for intranasal lesions. The most effective strategies to prevent trauma are the use of a hydrocolloid at the beginning of the support ventilation, the preferential use of a mask and the rotation of ventilation interfaces.
Conclusion:
Nasal injuries with continuous positive airway pressure treatment in preterm newborn infants were frequent and can induce pain, discomfort and sequelae. The immature skin of preterm newborn infants needs specific attention from trained caregivers and awareness by parents.
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