A comparison of nasal trauma in preterm infants extubated to either heated humidified high-flow nasal cannulae or nasal continuous positive airway pressure

Abstract

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.

Nurses' experiences by using heated humidified high flow cannula to premature infants versus nasal continuous positive airway pressure

“…Less nose damage is supported by previous research (Collins et al, 2013(Collins et al, , 2014Hochwald and Osiovich, 2010;Ignacio and Alfaleh, 2013;Manley et al, 2012;Shoemaker et al, 2007;Trevisanuto et al, 2009). Previous studies do not indicate whether nCPAP caused problems for the rest of the face, as several of our informants noted.…”

“…The effects of HHHFNC and nCPAP have been compared, and several studies conclude that there is no difference in respiratory support (Collins et al, 2013;Holleman-Duray et al, 2007;Ignacio and Alfaleh, 2013;Shoemaker et al, 2007;Yoder et al, 2013). However, several studies have shown that HHHFNC provides less nasal trauma than nCPAP (Collins et al, 2014;Hochwald and Osiovich, 2010;Shoemaker et al, 2007;Trevisanuto et al, 2009). Manley et al (2012) examined nursing staff's experiences with HHHFNC and found that babies were perceived to have increased mobility and comfort, that parents were less fearful, and that HHHFNC made it easier to breastfeed than nCPAP.…”

High-Flow Nasal Cannula Oxygen Therapy in Adults: Physiological Benefits, Indication, Clinical Benefits, and Adverse Effects

“…Since the interface of nasal CPAP requires secure fixing without leaks, the reported incidence of pressure ulcers ranges from 15 to 100%. 35 The same study reported less nasal trauma with HFNC, an open system in which leaks are not a concern. Adult patients also show less skin damage with HFNC than with bi-level positive airway pressure treatment.…”

Neonatal pressure ulcers: prevention and treatment

“…Some of these factors are the presence of ostomies or drainage, excess regurgitation or sialorrhea and the presence of noninvasive mechanical ventilation with heated and humidified systems (especially those systems that condense the water in the tubes). [57][58][59][60][61][62][63][64][65][66] The main nursing care practices that can reduce humidity and therefore the PU risk are changing diapers, cleaning and drying the area after each episode of incontinence, 67 applying absorbent dressings between the devices and the skin according to the needs of absorption (polyurethane, alginate, hydrocolloid fibers), 62 and/or using barrier products tested in neonatal patients (creams, lotions, pastes and/or emollients enriched with zinc oxide, polyurethane spreads, molding pastes, silicones). 40 …”