Nasal Injuries Related to Respiratory Support Interfaces in Preterm Infants: Neonatal Course and 12-Month Outcome

Area of Science:

• Neonatology
• Pediatric Dermatology
• Medical Device Technology

Background:

• Preterm infants' delicate skin is vulnerable to breakdown from respiratory support devices.
• Nasal injuries are a significant concern in neonates requiring mechanical ventilation.
• Immature skin integrity in premature infants increases risk of injury from medical equipment.

Purpose of the Study:

• To investigate the incidence and severity of nasal injuries in preterm infants due to respiratory support.
• To evaluate the short-term and medium-term sequelae of these nasal injuries.
• To identify factors associated with the development and outcome of respiratory support-related nasal injuries.

Main Methods:

• Prospective observational study of preterm infants (<33 weeks gestational age) with nasal injuries.
• Utilized a validated scale to record injury severity at multiple time points (inclusion, 3, 7, 28 days).
• Assessed sequelae at discharge and at 4, 9, and 12 months post-menstrual age.

Main Results:

• 23% of infants (64/276) developed nasal injuries, primarily stage 1 or 2.
• Continuous positive airway pressure (CPAP) was the most frequent interface associated with injury (83%).
• 59% of infants showed sequelae at discharge, with 66% experiencing esthetic sequelae at 12 months.

Conclusions:

• Nasal injuries are frequent complications of respiratory support in preterm infants.
• A significant proportion of infants experience medium-term sequelae, including scarring and esthetic changes.
• Injury site and type of respiratory support influence injury evolution and outcomes.