Incidence of nasal trauma associated with nasal prong versus nasal mask during continuous positive airway pressure treatment in very low birtiweight infants: a randomised control study
Incidence of nasal trauma associated with nasal prong versus nasal mask during continuous positive airway pressure treatment in very low birtiweight infants: a randomised control study
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DOI：
10.1136/adc.2004.069351
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发表时间：
2005-11-01
影响因子：
4.4
通讯作者：
Boo, NY
中科院分区：
文献类型：
--
作者：
Yong, SC;Chen, SJ;Boo, NY
目的：比较极低出生体重儿在经鼻持续气道正压通气（nCPAP）支持期间使用鼻叉或面罩相关鼻创伤的发生率（<1501 g）婴儿。设计：随机对照临床试验。设置：三级护理大学医院，儿科系，吉隆坡，马来西亚。方法：所有在2001年7月至2003年12月期间入住新生儿重症监护室并通过婴儿流量驱动器接受nCPAP的极低出生体重婴儿均被随机分配使用鼻叉或面罩。这些婴儿的鼻腔进行检查，每天在第一周，然后每周一次，直到他们断奶nCPAP。结果：在89名婴儿招募，41名被随机分配到面罩组和48的叉子组。两组鼻外伤的发生率无显著差异（p = 0.5）。鼻罩组和鼻叉组婴儿的原发创伤部位分别位于鼻中隔和人中交界处和鼻中隔壁。Logistic回归分析显示，在控制了出生体重、胎龄和使用鼻装置后，nCPAP持续时间是与鼻损伤发生相关的唯一显著危险因素。（调整后的比值比1.04; 95%置信区间1.01至1.07; p = 0.003）。无论使用哪种鼻装置，nCPAP治疗期间鼻创伤都很常见，因此应尽快终止。
Objective: To compare the incidence of nasal trauma associated with the use of prong or mask during nasal continuous positive airway pressure (nCPAP) support in very low birthweight (< 1501 g) infants.Design: Randomised controlled clinical trial.Setting: Tertiary care university hospital, Department of Paediatrics, Kuala Lumpur, Malaysia.Methods: All very low birthweight infants admitted to the neonatal intensive care unit between July 2001 and December 2003 who received nCPAP through the infant Flow Driver were randomised to the use of either nasal prong or mask. The nasal cavity of these infants was inspected daily during the first week and then weekly until they were weaned off nCPAP.Results: Of the 89 infants recruited, 41 were randomised to the mask group and 48 to the prong group. There was no significant difference in the incidence of nasal trauma between the two groups (p = 0.5). The primary site of trauma was at the junction between the nasal septum and the philtrum in infants in the mask group and the walls of the nasal septum in the prong group. Logistic regression analysis showed that duration of nCPAP was the only significant risk factor associated with development of nasal injury, after birth weight, gestational age, and nasal device used had been controlled for (adjusted odds ratio 1.04; 95% confidence interval 1.01 to 1.07; p = 0.003).Conclusion: Irrespective of the type of nasal device used, nasal trauma is common during nCPAP treatment, which should therefore be terminated as soon as possible.