Journal
EUROPEAN JOURNAL OF PEDIATRICS
Volume 173, Issue 2, Pages 181-186Publisher
SPRINGER
DOI: 10.1007/s00431-013-2139-8
Keywords
Nasal trauma; NCPAP; High-flow nasal cannulae
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Funding
- Medical Research Foundation for Women and Babies, Melbourne, Australia
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The objectives of this study were (1) to devise a nasal trauma score for preterm infants receiving non-invasive respiratory support, (2) to compare the incidence of nasal trauma in preterm infants < 32 weeks gestation randomised to either nasal continuous positive airway pressure (NCPAP) or heated humidified high-Flow nasal cannulae (HHHFNC), in the first 7 days post-extubation and (3) to assess the effect of two different nasal dressings in those assigned to NCPAP. We randomly assigned preterm ventilated infants to receive VapothermA (R) HHHFNC or NCPAP post-extubation. Infants receiving HHHFNC were treated with Sticky WhiskersA (R) and infants receiving NCPAP received either Sticky WhiskersA (R) or CannualaideA (R) nasal dressings. Bedside nursing staff scored six sites on each infant's nose for erythema, bleeding or ulceration. Scores were recorded three times daily for the first 7 days post-extubation. The sum of these 21 scores was used as the summary measure of nasal trauma. The mean nasal trauma score for infants assigned HHHFNC was 2.8 (SD 5.7) compared to 11.7 for NCPAP (SD 10.4), p < 0.001. There was no difference in mean trauma score between infants on NCPAP assigned Sticky WhiskersA (R) 14.4 (SD 12.5) or CannualaideA (R) 9.5 (SD 7.3), p = 0.06. Conclusion: HHHFNC resulted in significantly less nasal trauma in the first 7 days post-extubation than NCPAP and was most significant in infants < 28 weeks of gestation. The use of protective dressings was not associated with decreased nasal trauma for infants on NCPAP.
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