Nasal injury in preterm infants receiving non-invasive respiratory support: a systematic review

Imbulana, Dilini I; Manley, Brett J.; Dawson, Jennifer A; Davis, Peter G; Owen, Louise

doi:10.1136/archdischild-2017-313418

Cited by 95 publications

(107 citation statements)

References 49 publications

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“…A similar meta-analysis (only for nasal trauma) performed in a recent systematic review 9. A borderline reduction (RR (95% CI) 0.80 (0.64 to 1.00); P=0.05) in the rate of nasal injury is seen in infants receiving mask NCPAP.…”

Section: Summary Of Evidencementioning

confidence: 82%

Should nasal mask or binasal prongs be used for continuous positive airway pressure in preterm infants?

Razak¹

2018

Arch Dis Child

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Section: Summary Of Evidencementioning

confidence: 82%

Should nasal mask or binasal prongs be used for continuous positive airway pressure in preterm infants?

Razak¹

2018

Arch Dis Child

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“…More specifically, a meta‐study by Imbulana et al. () found that between 20 and 100% of premature infants sustained a nasal injury attributable to binasal prong CPAP. Furthermore, the use of mechanical ventilation was found to increase infections among neonates (Tan et al.…”

Section: Introductionmentioning

confidence: 99%

Improving nursing knowledge and care for neonates with respiratory distress in Jordan

Ali

Obeisat

Tarawneh

2019

International Nursing Review

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Aim This study evaluates the effectiveness of an educational intervention in the area of nursing knowledge and practice relating to neonatal respiratory distress syndrome. Background In Jordan, respiratory distress is the leading cause of death among neonates. Recent studies have revealed a knowledge deficit relating to respiratory distress among nurses in neonatal intensive care units, hence the need for advanced training and specialization in this area. Methods A quasi‐experimental, repeated‐measures, one‐group pre‐test–post‐test design was used to assess the effectiveness of the educational intervention. A convenience sample of 48 nurses was recruited from three hospitals in northern Jordan. A self‐reporting questionnaire was used to assess the respondents’ knowledge of respiratory distress and an observational checklist to assess their practice. The study intervention consisted of 12 two‐hour lecture‐based interactive teaching sessions lasting 4 weeks. A follow‐up assessment was conducted 1 month after the post‐test. Results The baseline assessment revealed that more than half of the nurses scored low on knowledge and the majority scored low on practice. One‐way repeated ANOVA showed that post‐test and follow‐up test scores on nursing knowledge and practice were significantly higher than the baseline scores. Conclusion The study findings show the efficacy of educational interventions in enhancing nursing knowledge and practice relating to the care of neonates with respiratory distress. Implications for nursing and health policy For neonatal nurses, periodic teaching and training interventions are essential to ensuring the quality nursing care required to reduce morbidity and mortality rates among neonates. Health policymakers should support nurses in pursuing educational opportunities aimed at enhancing their knowledge of advanced neonate care.

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“…Unfortunately, nCPAP delivery systems are associated with significant risk of nasal trauma [10, 11]. Imbulana et al [11] assessed the incidence of and risk factors for nasal injury in preterm infants.…”

Section: Introductionmentioning

confidence: 99%

“…Imbulana et al [11] assessed the incidence of and risk factors for nasal injury in preterm infants. In their systematic review including 45 trials, the reported incidence of nasal injury in preterm infants receiving nCPAP ranged from 20 to 100%.…”

Section: Introductionmentioning

confidence: 99%

Nasal High-Flow Therapy as Primary Respiratory Support for Preterm Infants without the Need for Rescue with Nasal Continuous Positive Airway Pressure

et al. 2018

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Aim: To evaluate the effectiveness of nasal high-flow therapy (nHFT) as primary respiratory support for preterm infants with respiratory distress syndrome (RDS) in two tertiary neonatal units. Methods: A retrospective outcome analysis of initial respiratory support strategies was performed in two tertiary neonatal units in the UK: John Radcliffe Hospital (JRH), Oxford and St Peter’s Hospital (SPH), Chertsey. Infants born between 28⁺⁰ and 36⁺⁶ weeks gestational age (GA) between May 2013 and June 2015 were included. Results: A total of 381 infants, 191 from JRH and 190 from SPH, were analysed. Infants were stabilised in the delivery room using mask continuous positive airway pressure followed by nHFT. Endotracheal intubation was performed according to local protocols, depending on the severity of RDS. There were significant differences in initial intubation rates according to GA (26% JRH vs. 16.9% SPH, p < 0.001 for babies < 32 weeks GA, and 8.2% JRH vs. 6.5% SPH, p < 0.001 for babies > 32 weeks GA); however, most infants were successfully transitioned to nHFT. Intubation rates during the first 72 h were comparable between centres (14.7% JRH vs. 11.1% SPH, p = 0.29). There were no differences in neonatal morbidities, including air leak, duration of oxygen supplementation, bronchopulmonary dysplasia, sepsis, retinopathy of prematurity, intraventricular haemorrhage, necrotising enterocolitis, or median time to full-suck feeds. Conclusion: Use of nHFT for primary respiratory support, without use of nasal continuous positive airway pressure as “rescue” treatment, resulted in intubation rates lower or comparable to published data from randomised controlled trials.

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Nasal injury in preterm infants receiving non-invasive respiratory support: a systematic review

Abstract: Nasal injury is common in preterm infants born <30 weeks' gestational age receiving CPAP via binasal prongs. Larger randomised trials are required to fully evaluate strategies to reduce nasal injury.

Cited by 95 publications

References 49 publications

Should nasal mask or binasal prongs be used for continuous positive airway pressure in preterm infants?

Should nasal mask or binasal prongs be used for continuous positive airway pressure in preterm infants?

Improving nursing knowledge and care for neonates with respiratory distress in Jordan

Nasal High-Flow Therapy as Primary Respiratory Support for Preterm Infants without the Need for Rescue with Nasal Continuous Positive Airway Pressure

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