Advantages and disadvantages of different nasal CPAP systems in newborns

Abstract

The naso-pharyngeal tube is an easy, safe and economical CPAP system usable with every common ventilator. For very low birth weight newborns, a prong system may have advantages.

The frequency of nasal injury in newborns due to the use of continuous positive airway pressure with prongs

“…The mild stage is described as redness or nasal hyperemia; the moderate presents bleeding injuries and the severe stage refers to injuries with necrosis (5) .…”

“…Nasal lesions caused in newborns due to misuse of prongs vary from simple hyperemia of the nasal mucosa, bleeding, formation of crusts, and necrosis up to total destruction of the anterior part of the septum (columella) (6)(7) and nasal septum (5,8) .…”

Hydrocolloid dressing in preventing nasal trauma secondary to nasal continuous positive airway pressure in preterm infants

“…[5,6] The local pressure of nasal prongs to the nasal region is easy to cause nasal injury in the newborn due to the cutaneous vulnerability. [6,7] Besides anatomical factors, such as endvascularization of the columella and nostrils, [8] Diblasi [9] emphasized that fixation technique was also an important factor for selecting the proper hat and prongs. The lack of stabilization and, hence, excessive movement of the prongs could result in nasal injury, interface displacement, and loss of system pressure.…”

Nasal respiratory support through the nares: its time has come

“…25 As for the type of the flow generator, studies have shown no significant difference in outcomes using the different types of flow generators to deliver NCPAP. 26 Extubation failures requiring reintubation ranged from 20 to 80% in infants managed on NCPAP with higher failure rates in extremely low birth weight infants. Most common reasons for failures of the use of NCPAP included repeated episodes of apnea, desaturation, bradycardia or respiratory acidosis.…”