Effectiveness of hydrocolloid nasal dressing pads in preventing nasal ulceration in preterm infants using non-invasive ventilation

MedPharmRes ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 46-51
Author(s):  
Chau Vu Bao Nguyen ◽  
Tinh Thu Nguyen ◽  
Tam Thi Thanh Pham ◽  
Sen Thi Hong Lam ◽  
Le An Pham ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Nasal Cannula ◽  
The Other ◽  
Control Group ◽  
Invasive Ventilation ◽  
Nasal Bridge ◽  
Non Invasive ◽  
Hydrocolloid Dressing ◽  
Non Invasive Ventilation

Background: The use of non-invasive ventilation (NIV) in preterm infants is becoming increasingly common. The use of cannula in NIV can cause ulceration of the nasal bridge with the current practices using the thin foam patches. This study aims to evaluate the effectiveness of hydrocolloid nasal dressing pads in preventing nasal ulceration comparing to that of the thin foam patches. Methods: A prospective cohort study using hydrocolloid dressing pads (1 November to 30 April 2020) was compared to that of a historical control group using thin foam dressing (1 April to 15 October 2019) to evaluate the effectiveness of hydrocolloid dressing pads. All participants were preterm infants (less than 37 weeks of gestational age) and used nasal cannula NIV at the Department of Neonatal Intensive Care (NICU), Children's Hospital 1. Results: 71 infants used hydrocolloid dressing pads, and 42 used ordinary thin foam nasal dressings. In the hydrocolloid dressings group, two infants (2.8%) had nasal ulcers; among them, one was mild, and the other was moderate. In comparison, ten infants (23.8%) using thin foam dressings developed ulcers, of which seven were mild, two were moderate, and one was severe. Using hydrocolloid nasal dressings significantly reduced nasal ulceration compared to thin foam dressings (OR = 0.09, 95%CI = 0.02 – 0.45). Conclusion: Using hydrocolloid nasal dressings for preterm infants on nasal cannula NIV significantly reduced nasal ulceration compared to ordinary thin foam dressings.

scholarly journals Reintubation rates after extubation to different non-invasive ventilation modes in preterm infants

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alaa Masry ◽  
Nuha A. M. A. Nimeri ◽  
Olfa Koobar ◽  
Samer Hammoudeh ◽  
Prem Chandra ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Neonatal Morbidity ◽  
Intermittent Positive Pressure Ventilation ◽  
Nasal Cannula ◽  
Positive Pressure ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Increased Risk

Abstract Introduction Respiratory Distress Syndrome (RDS) is a common cause of neonatal morbidity and mortality in premature newborns. In this study, we aim to compare the reintubation rate in preterm babies with RDS who were extubated to Nasal Continuous Positive Airway Pressure (NCPAP) versus those extubated to Nasal Intermittent Positive Pressure Ventilation (NIPPV). Methods This is a retrospective study conducted in the Neonatal Intensive Care Unit (NICU) of Women’s Wellness and Research Center (WWRC), Doha, Qatar. The medical files (n = 220) of ventilated preterm infants with gestational age ranging between 28 weeks 0 days and 36 weeks + 6 days gestation and extubated to non-invasive respiratory support (whether NCPAP, NIPPV, or Nasal Cannula) during the period from January 2016 to December 2017 were reviewed. Results From the study group of 220 babies, n = 97 (44%) babies were extubated to CPAP, n = 77 (35%) were extubated to NIPPV, and n = 46 (21%) babies were extubated to Nasal Cannula (NC). Out of the n = 220 babies, 18 (8.2%) were reintubated within 1 week after extubation. 14 of the 18 (77.8%) were reintubated within 48 h of extubation. Eleven babies needed reintubation after being extubated to NCPAP (11.2%) and seven were reintubated after extubation to NIPPV (9.2%), none of those who were extubated to NC required reintubation (P = 0.203). The reintubation rate was not affected by extubation to any form of non-invasive ventilation (P = 0.625). The mode of ventilation before extubation does not affect the reintubation rate (P = 0.877). The presence of PDA and NEC was strongly associated with reintubation which increased by two and four-folds respectively in those morbidities. There is an increased risk of reintubation with babies suffering from NEC and BPD and this was associated with an increased risk of hospital stay with a P-value ranging (from 0.02–0.003). Using multivariate logistic regression, NEC the NEC (OR = 5.52, 95% CI 1.26, 24.11, P = 0.023) and the vaginal delivery (OR = 0.23, 95% CI 0.07, 0.78, P = 0.018) remained significantly associated with reintubation. Conclusion Reintubation rates were less with NIPPV when compared with NCPAP, however, this difference was not statistically significant. This study highlights the need for further research studies with a larger number of neonates in different gestational ages birth weight categories. Ascertaining this information will provide valuable data for the factors that contribute to re-intubation rates and influence the decision-making and management of RDS patients in the future.

scholarly journals Short-term effects of synchronized vs. non-synchronized NIPPV in preterm infants: study protocol for an unmasked randomized crossover trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Francesco Cresi ◽  
Federica Chiale ◽  
Elena Maggiora ◽  
Silvia Maria Borgione ◽  
Mattia Ferroglio ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Work Of Breathing ◽  
Respiratory Rhythm ◽  
Assisted Ventilation ◽  
Positive Pressure ◽  
Invasive Ventilation ◽  
Short Term ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Short Term Effects

Abstract Background Non-invasive ventilation (NIV) has been recommended as the best respiratory support for preterm infants with respiratory distress syndrome (RDS). However, the best NIV technique to be used as first intention in RDS management has not yet been established. Nasal intermittent positive pressure ventilation (NIPPV) may be synchronized (SNIPPV) or non-synchronized to the infant’s breathing efforts. The aim of the study is to evaluate the short-term effects of SNIPPV vs. NIPPV on the cardiorespiratory events, trying to identify the best ventilation modality for preterm infants at their first approach to NIV ventilation support. Methods An unmasked randomized crossover study with three treatment phases was designed. All newborn infants < 32 weeks of gestational age with RDS needing NIV ventilation as first intention or after extubation will be consecutively enrolled in the study and randomized to the NIPPV or SNIPPV arm. After stabilization, enrolled patients will be alternatively ventilated with two different techniques for two time frames of 4 h each. NIPPV and SNIPPV will be administered with the same ventilator and the same interface, maintaining continuous assisted ventilation without patient discomfort. During the whole duration of the study, the patient’s cardiorespiratory data and data from the ventilator will be simultaneously recorded using a polygraph connected to a computer. The primary outcome is the frequency of episodes of oxygen desaturation. Secondary outcomes are the number of the cardiorespiratory events, FiO2 necessity, newborn pain score evaluation, synchronization index, and thoracoabdominal asynchrony. The calculated sample size was of 30 patients. Discussion It is known that NIPPV produces a percentage of ineffective acts due to asynchronies between the ventilator and the infant’s breaths. On the other hand, an ineffective synchronization could increase work of breathing. Our hypothesis is that an efficient synchronization could reduce the respiratory work and increase the volume per minute exchanged without interfering with the natural respiratory rhythm of the patient with RDS. The results of this study will allow us to evaluate the effectiveness of the synchronization, demonstrating whether SNIPPV is the most effective non-invasive ventilation mode in preterm infants with RDS at their first approach to NIV ventilation. Trial registration ClinicalTrials.gov NCT03289936. Registered on September 21, 2017.

scholarly journals Incidence and Severity of Nasal Injuries in Preterm Infants Associated to Non-Invasive Ventilation Using Short Binasal Prong

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110104
Author(s):  
Débora de Fátima Camillo Ribeiro ◽  
Frieda Saicla Barros ◽  
Beatriz Luci Fernandes ◽  
Adriane Muller Nakato ◽  
Percy Nohama
Keyword(s):  
Preterm Infants ◽  
Professional Competence ◽  
Stage I ◽  
Stage Ii ◽  
Invasive Ventilation ◽  
Cause And Effect ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Nasal Injury ◽  
Cause And Effect Diagram

Short binasal prongs can cause skin and mucosal damage in the nostrils of preterm infants. The objective of this study was to investigate the incidence and severity of nasal injuries in preterm infants during the use of short binasal prongs as non-invasive ventilation (NIV) interfaces. A prospective observational study was carried out in the public hospital in a Southern Brazil. The incidence and severity of internal and external nasal injuries were evaluated in 28 preterm infants who required NIV using short binasal prongs for more than 24 hours. In order to identify possible causes of those nasal injuries, the expertise researcher physiotherapist has been carried empirical observations, analyzed the collected data, and correlated them to the literature data. A cause and effect diagram was prepared to present the main causes of the nasal injury occurred in the preterm infants assessed. The incidence of external nasal injuries was 67.86%, and internal ones 71.43%. The external nasal injuries were classified as Stage I (68.42%) and Stage II (31.58%). All the internal injuries had Stage II. The cause and effect diagram was organized into 5 categories containing 17 secondary causes of nasal injuries. There was a high incidence of Stage II-internal nasal injury and Stage I-external nasal injury in preterm infants submitted to NIV using prongs. The injuries genesis can be related to intrinsic characteristics of materials, health care, neonatal conditions, professional competence, and equipment issues.

scholarly journals Clinical profile of newborns undergoing physical therapy in a neonatal intensive care unit

2016 ◽  
Vol 29 (3) ◽  
pp. 553-560 ◽  
Author(s):  
Graziela Ferreira Biazus ◽  
Cidia Cristina Kupke
Keyword(s):  
Birth Weight ◽  
Physical Therapy ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Extremely Low Birth Weight ◽  
Invasive Ventilation ◽  
Weight Group ◽  
Non Invasive ◽  
Birth Weight Group ◽  
Non Invasive Ventilation

Abstract Introduction: In neonatal therapy units, physical therapy is directed toward integral baby care. Objective: To describe the profile of newborns (NBs) hospitalized in a Neonatal Intensive Care Unit (NICU). Methods: Retrospective documentary study with data collection from medical records from July 2011 to July 2013. The sample consisted of NBs who performed motor and respiratory therapy. Data were grouped into five categories according to birth weight (≤ 1000g, 1001-1500g, 1501-2000g, 2001-2500g, ≥ 2501g). Results: total of 1,884 newborns were admitted to the NICU within the stipulated period, 168 (13.9%) underwent physical therapy. Of the 168 NBs who underwent physical therapy, 137 were born in the hospital (81.5%) and 31 were transferred there (18.5%); 17 of these babies died during the neonatal hospital stay (10.1%). All newborns of the extremely low birth weight group (≤ 1000g) required mechanical ventilation, 72.7% non-invasive ventilation and 16.6% high-frequency oscillatory ventilation. The occurrence of pneumothorax in the extremely low birth weight group was 13.8% and 16% in the group with birth weight 1001-1500g. Conclusion: Infants with low birth weight (<2500g) constituted the profile of NBs who underwent physical therapy, which was directly related to higher incidence of death and pneumothorax, as well as increased use of mechanical and non-invasive ventilation.

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