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Arch Otolaryngol Head Neck Surg. 2010 Mar;136(3):287-91. doi: 10.1001/archoto.2010.15.

Effects of nasal continuous positive airway pressure and cannula use in the neonatal intensive care unit setting.

Author information

1
Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Medical Center, Nationwide Children's Hospital, Columbus, 43212, USA. Kris.Jatana@osumc.edu

Abstract

OBJECTIVE:

To investigate the effects of nasal continuous positive airway pressure (CPAP) and cannula use in the neonatal intensive care unit.

DESIGN:

Cross-sectional study.

SETTING:

Tertiary care children's hospital.

PATIENTS:

One hundred patients (200 nasal cavities), younger than 1 year, who received at least 7 days of nasal CPAP (n = 91) or cannula supplementation (n = 9) in the neonatal intensive care unit.

INTERVENTIONS:

External nasal examination and anterior nasal endoscopy with photographic documentation.

MAIN OUTCOME MEASURES:

The incidence and characteristics of internal and external nasal findings of patients with nasal CPAP or cannula use.

RESULTS:

Nasal complications were seen in 12 of the 91 patients (13.2%) with at least 7 days of nasal CPAP exposure, while no complications were seen in the 9 patients with nasal cannula use alone. The external nasal finding of columellar necrosis, seen in 5 patients (5.5%), occurred as early as 10 days after nasal CPAP use. Incidence of intranasal findings attributed to CPAP use, in the 182 nostrils examined, included ulceration in 6 nasal cavities (3.3%), granulation in 3 nasal cavities (1.6%), and vestibular stenosis in 4 nasal cavities (2.2%). Intranasal complications were seen as early as 8 to 9 days after nasal CPAP administration. Nasal complications from CPAP were associated with lower Apgar scores at 1 (P = .02) and 5 (P = .06) minutes.

CONCLUSIONS:

External or internal complications of nasal CPAP can be relatively frequent (13.2%) and can occur early, and patients with lower Apgar scores may be at higher risk. Close surveillance for potential complications should be considered during nasal CPAP use.

PMID:
20231649
PMCID:
PMC3740519
DOI:
10.1001/archoto.2010.15
[Indexed for MEDLINE]
Free PMC Article

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