Comparative study of nasal mask versus nasal prong in terms of nasal septal necrosis for delivering nasal continuous positive airway pressure in newborns with respiratory distress

Abstract

Background: Respiratory distress syndrome (RDS) requires management by oxygen therapy and mechanical ventilation. Continuous positive airway pressure (CPAP) being simple, cost-effective, and non-invasive respiratory support is used to prevent airway injury as well as the development of bronchopulmonary dysplasia. Objectives: The study was to describe the comparison of nasal septum necrosis and to categorize severity of nasal septum trauma while using nasal prongs and nasal masks for nasal CPAP (nCPAP) in neonates with RD. Materials and Methods: A prospective randomized controlled study was carried out in 200 neonates admitted in neonatal intensive care unit and these neonates were randomized to receive either nasal mask or nasal prong as an interface for nCPAP. Complete blood count, C-reactive protein, blood culture, and chest X-ray were done. All infants were observed for 72 h for the development of nasal septal necrosis in each interface. All variables were analyzed with the help of Chisquare test. Results: Of the total 200 neonates included in the study, 9% neonates of prong group developed nasal septum necrosis, while no incidence of septum necrosis noted in mask group. Conclusion: Nasal masks were comparatively better than nasal prongs as nasal septum trauma occurred only in neonates with nasal prongs group.

Bubble Nasal Continuous Positive Airway Pressure (bNCPAP): An Effective Low-Cost Intervention for Resource-Constrained Settings

“…Nasal masks apply excessive constant pressure to the nasal bridge and philtrum, reducing local tissue perfusion and causing nasal injury [ 50 ]. On the contrary, binasal prong injury is mainly observed at the columella and anterior part of nasal septum [ 18 , 50 , 55 ], which may be due to constant pressure between the two prongs [ 50 ]. Whilst long-term sequelae are uncommon, nasal injury may cause permanent disfigurement and functional sequelae such as nasal vestibular stenosis, nasal deformity, and visible scars requiring cosmetic surgery [ 46 , 56 ].…”