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. 2013 Jul-Sep;25(3):245-50.
doi: 10.5935/0103-507X.20130042.

Early nasal injury resulting from the use of nasal prongs in preterm infants with very low birth weight: a pilot study

[Article in English, Portuguese]
Nathalie Tiemi Ota  1 , Josy Davidson, Ruth Guinsburg
Affiliations

Early nasal injury resulting from the use of nasal prongs in preterm infants with very low birth weight: a pilot study

[Article in English, Portuguese]
Nathalie Tiemi Ota et al. Rev Bras Ter Intensiva. 2013 Jul-Sep.

Abstract
in English, Portuguese

Objective: To analyze the incidence of early-onset nasal injury in infants with very low birth weight and indication for noninvasive ventilation via nasal prongs.

Methods: A prospective case series of infants with gestational age <37 weeks, weight <1.500 g and postnatal age <29 days. The patients were evaluated three times daily from the installation of nasal prongs to the 3rd day of use. The patients' clinical conditions and the device's characteristics and its application were analyzed. The initial analysis was descriptive, indicating the prevalence of nasal injury and factors associated with it. Categorical data were analyzed using the chi-squared test or Fisher's exact test, and numerical data were analyzed using the t-test or the Mann-Whitney test.

Results: Eighteen infants were included; 12 (with a gestational age of 29.8 ± 3.1 weeks, birth weight of 1.070 ± 194 g and a Score for Neonatal Acute Physiology - Perinatal Extension (SNAPPE) of 15.4 ± 17.5) developed nasal injuries (injury group), and 6 (with a gestational age of 28.0 ± 1.9 weeks, weight of 1.003 ± 317 g and SNAPPE of 26.2 ± 7.5) showed no nasal injury (uninjured group). The injury group subjects were more often male (75% versus 17%), and their injuries appeared after an average of 18 hours, predominantly during the night (75%).

Conclusion: The incidence of nasal injury in preterm infants who experienced noninvasive ventilation via nasal prongs was high, and a study of associated factors may be planned based on this pilot.

Objetivo: Analisar, em recém-nascidos de muito baixo peso e com indicação de ventilação não invasiva via pronga nasal, a incidência do aparecimento precoce de lesão nasal.

Métodos: Série de casos prospectiva de nascidos com idade gestacional <37 semanas, peso <1.500g e idade pós-natal <29 dias. Os pacientes foram avaliados desde a instalação da pronga nasal até o 3o dia de uso, três vezes ao dia. Foram analisadas as condições clínicas dos pacientes, características do dispositivo e de sua aplicação. A análise inicial foi descritiva, verificando-se a prevalência de lesão nasal bem como os fatores a ela associados. Os dados categóricos foram analisados por qui-quadrado ou exato de Fisher e os dados numéricos, por teste t ou Mann-Whitney.

Resultados: Dezoito recém-nascidos foram incluídos, dos quais 12 (idade gestacional de 29,8±3,1 semanas, peso ao nascer de 1.070±194g e Score for Neonatal Acute Phisiology - Perinatal Extension (SNAPPE) de 15,4±17,5) evoluíram com lesão nasal (Grupo Lesão) e 6 (idade gestacional de 28,0±1,9 semanas, peso de 1.003±317g e SNAPPE de 26,2±7,5) não apresentaram lesão nasal (Grupo Sem Lesão). No Grupo Lesão, houve maior frequência do gênero masculino (75% versus 17%), a lesão apareceu em média após 18 horas e predominantemente no período notur no (75%).

Conclusão: A incidência de lesão nasal em prematuros submetidos à ventilação não invasiva via pronga nasal foi elevada, sendo possível planejar estudo dos fatores associados, com base neste piloto.

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Conflict of interest statement

Conflicts of interest: None.

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