A three group prospective randomized experimental design was conducted to identify differences in frequency and severity of nasal injuries when comparing various interfaces used during continuous positive airway pressure (CPAP) and identified risk factors associated with injury. Seventy-eight neonates <1500g were randomized into three groups: continuous nasal prongs; continuous nasal mask; or alternating mask/prongs. Repeated measures ANOVA with Bonferroni correction demonstrated that significantly less skin injury was detected in the rotation interface group when compared to both mask and prong groups. In the final stepwise regression model (F=11.51; R2=0.221; p=0.006) significant predictors of skin injury included number of days on nasal CPAP (p<0.001) and current mean post menstrual age (p=0. 006). Reduced nasal injury was demonstrated using rotating mask/prong nasal interfaces. Future best practices must include precise selection of device size, developmental and CPAP device positioning with focused skin assessment including rapid intervention for skin injury.
- Nasal CPAP of the neonate
- Nasal trauma
- Pressure ulcer
- Preterm infant nasal skin breakdown
- Skin breakdown during nasal CPAP
ASJC Scopus subject areas