A comparative effectiveness study of continuous positive airway pressure-related skin breakdown when using different nasal interfaces in the extremely low birth weight neonate

Katherine M. Newnam, Jacqueline M. McGrath, Jeanne Salyer, Tracy Estes, Nancy Jallo, W. Thomas Bass

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)36-41
Number of pages6
JournalApplied Nursing Research
Volume28
Issue number1
DOIs
StatePublished - Feb 1 2015
Externally publishedYes

Keywords

  • Nasal CPAP of the neonate
  • Nasal trauma
  • Pressure ulcer
  • Preterm infant nasal skin breakdown
  • Skin breakdown during nasal CPAP

ASJC Scopus subject areas

  • Nursing(all)

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