Incidence of nasal pressure injury in preterm infants on nasal mask noninvasive ventilation

Abstract

Objective The aim of this study was to evaluate the incidence of nasal injury in preterm newborns (NB) using the Neonatal Skin Condition Score within 7 days of noninvasive ventilation (NIV) and to compare the incidence of injury in NB weighing ≥1,000 g and those weighing <1,000 g at the time of initiation of NIV support. Methods This is a prospective, observational study carried out in a neonatal intensive care unit of a public hospital in Rio Grande do Sul from July 2016 to January 2021. Patients were stratified into two groups at the time of NIV initiation: group 1 (weight ≥1,000 g) and group 2 (weight <1,000 g). To assess the condition of nasal injury, a rating scale called the Neonatal Skin Condition Score was applied during the first seven consecutive days on NIV. Kaplan-Meier, log-rank test, and Cox proportional hazards regression were used to estimate the hazard ratio (HR) and 95% confidence interval (CI). Results In total, 184 NB were evaluated. Nasal injury was reported in 55 (30%) NB. The risk of nasal injury was 74% higher in group 2 (19/45) than in group 1 (36/139) (HR: 1.74; 95%CI 0.99–3.03, p=0.048). Conclusion The incidence of nasal injury in infants submitted to NIV by nasal mask was high, and the risk of this injury was greater in preterm infants weighing <1,000 g.

Nurses’ Performance Regarding Non-Invasive Ventilation of Neonates and its Relation to Associated Pressure Injuries

“…However, one of the major problems associated with using NIV in NICU is the occurrence of facial or nasal mucosal injuries. The incidence of nasal injury resulting from NIV in previous studies was 37.16% in the first stage, and 63.64% in the second stage (Biazus et al, 2023 andRibeiro et al, 2021). So, Neonates require special care at neonatal intensive care units provided by highly qualified nurses to enhance their health and decrease mortality rate (Elsobkey, 2018).…”