Influência da posição corporal no deslocamento da pronga nasal em recém‐nascido pré‐termo em pressão positiva contínua em vias aéreas

Abstract

Objective:To evaluate the influence of body position on the displacement of nasal prongs in preterm infants.Methods:This prospective, randomized, crossover study enrolled infants born at a mean gestational age of 29.7±2 weeks, birth weight of 1353±280g and 2.9±2.2 days of life, submitted to continuous positive airway pressure by nasal prongs. The main outcome was the number of times that the nasal prongs were displaced following infant positioning in the following body positions: prone, right lateral, left lateral, and supine, according to a pre-established random order. Moreover, cardiorespiratory variables (respiratory rate, heart rate, and oxygen saturation) were evaluated for each body position. Data for each position were collected every 10 min, over a period of 60 min. An occurrence was defined when the nasal prongs were displaced from the nostrils after 3 min in the desired position, requiring intervention of the examiner.Results:Among the 16 studied infants, the occurrence of nasal prong displacement was only observed in the prone position (9 infants - 56.2%) and in the left lateral position (2 infants - 12.5%). The number of times that the prongs were displaced was 11 in the prone position (7 within the first 10min) and 2 in the left lateral position (1 within the first 10min). No clinically significant changes were observed in the cardiorespiratory variables.Conclusions:Maintenance of the nasal prongs to provide adequate noninvasive respiratory support was harder in the prone position.

Continuous positive pressure on aircraft in neonates: care provided by the nursing team

“…1,23,27 Among the care the good positioning of the nasal prong is essential, and this happens when it does not deform the neonate's face, does not compress the nasal septum and does not allow the displacement of the interface in the nostrils' internal part. 4 Thus, there is the need for implementation of nursing actions in a systematized and standardized way, which aims at the best oxygenation and the reduction of the possible adverse effects caused by the use of the nasal CPAP with prong. 23 It is fundamental to implement protocols attached to its implementation rigidly in the care of neonates under NIV with other nursing care to aid in preventing some adverse effects of nasal CPAP use with prong.…”

“…This therapeutic presents as benefit the reduction of the invasive support need, improving pulmonary mechanic-related parameters and reduction of the respiratory work. 4,5 For this system interfaces are used, such as facial mask, nasal mask, orotracheal and nasopharingeal cannula, short single nasal prong, short nasopharingeal and binasal, and this later is the most used mainly in the northeast region of Brazil due to its easy application in the nasal region of the neonate. 1 However, its use can also cause some air leak-related complications, resulting in a decline of the offered pressure; to the drying up of the mucous membranes; the low tolerance by the neonate; in addition to barotraumas and abdominal distension.…”

A relação entre saturação de oxigênio, idade gestacional e nível de habilidade de alimentação oral de recém-nascido pré-termo

“…In contrast, all Level II and Level IV preterm infants presented satisfactory pre-and post-first oral feeding SpO 2 means and remained clinically stable during OF because of their high resistance. Risks in clinical stability are considered moderate if SpO 2 values are maintained between 85% and 80%, but they are severe if baseline SpO 2 is <80% (25) .…”

Desenvolvimento de protetor nasal anatômico para recém-nascidos em uso de pronga

“…Continuous Positive Airway Pressure (CPAP) has been widely used in many neonatal services as a non-invasive ventilatory mode for primary care in newborns with respiratory distress and after extubation (1) . It is characterized by the supply of a mixture of oxygen and compressed air by continuous positive pressure through different interfaces, with a short binasal prong being the most used (2) , made in different sizes and of flexible material (3) .…”