Nasal septum injury in preterm infants using nasal prongs

the study was a cohort from an open therapeutic intervention. The sample included 70 infants with a gestational age inferior to 37 weeks, who used nasal prongs and were hospitalized at the neonatal service of a hospital in Recife-PE, in the Northeast of Brazil. The data were collected in patient files through the assessment of the application of the device and of the nasal septum. Multinomial Logistic Regression and Survival analyses were applied.

RESULTS:

the incidence of nasal injury corresponded to 62.9%. In the multiple analysis, only the length of the infant's treatment was a determinant factor for the occurrence and severity of the injuries.

CONCLUSION:

the type of nasal prong does not serve as a risk factor for the nasal injury. The high incidence of nasal injury indicates the need to adapt the nursing care with emphasis on prevention.

Continuous Positive Airway Pressure; Premature; Wounds and Injuries; Nursing Care; Nursing

Factor assessed		Total n=70		Group under evaluation				p-value
		Total n=70		Reused prong n= 39		New prong n=31
		n	%	n	%	n	%
Injury
	Absent	26	37,1	17	43,6	9	29,0	0,211
	Present	44	62,9	22	56,4	22	71,0	0,211
	Stage EI	23	52,3	12	54,6	11	50,0	-
	Stage EII	16	36,4	7	31,8	9	40,9	-
	Stage EIII	5	11,3	3	13,6	2	9,1	-

Factor under evaluation			No injury		EI injury		EII and EIII injury		p-value
Factor under evaluation			n	%	n	%	n	%	p-value
Prong type									0.436*
	New		9	29.0	11	35.5	11	35.5
	Reused		17	43.6	12	30.8	10	25.6
Sex									0.826*
	Female		13	38.2	10	29.4	11	32.4
	Male		13	36.1	13	36.1	10	27.8
Gestational age									0.021^†
	<28 weeks		3	23.1	2	15.4	8	61.5
	28 to 31 weeks		6	35.3	4	23.5	7	41.2
	32 weeks or more		17	42.5	17	42.5	6	15.0
Weight of infant									0.179^†
		< 1000 g	5	33.3	4	26.7	6	40.0
		1000 to 1499 g	4	19.0	8	38.1	9	42.9
		1500 to 2499 g	13	48.1	8	29.6	6	22.2
		≥ 2500 g	4	57.1	3	42.9	0	0.0
Length of ventilation									<0.001^†
	2 days		16	69.6	7	30.4	0	0.0
	3 to 4 days		6	27.3	11	50.0	5	22.7
	5 to 6 days		2	15.4	3	23.1	8	61.5
	7 or more		2	16.7	2	16.7	8	66.7

Factor under Evaluation		Stage I			Stage II and III
Factor under Evaluation		OR*	CI^†	p-value	OR*	CI^†	p-value
Length of NIV
	2 days	Ref	Ref	Ref	Ref	Ref	Ref
	3 to 4 days	4.19	1.10 – 15.90	0.035	4.77 x 10⁸	‡	§
	5 to 6 days	3.43	0.46 – 25.27	0.227	2.29 x 10⁹	‡	<0.001
	7 or more	2.29	0.27 – 19.66	0.451	2.29 x 10⁹	‡	<0.001

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding Author: Suely de Fátima Santos Freire Bonfim Universidade Federal de Pernambuco. Hospital das Clínicas Av. Prof. Moraes Rego, 1235 Cidade Universitária CEP: 50670-901, Recife, PE, Brasil E-mail: sfbonfim@uol.com.br

Brasil

Brasil

Nasal septum injury in preterm infants using nasal prongs1 1 Paper extracted from master's thesis "Nasal septum injury in preterm neonates in using prongs" presented to Universidade Federal de Pernambuco, Recife, PE, Brazil

OBJECTIVE:

METHOD:

RESULTS:

CONCLUSION:

Nasal septum injury in preterm infants using nasal prongs¹ 1 Paper extracted from master's thesis "Nasal septum injury in preterm neonates in using prongs" presented to Universidade Federal de Pernambuco, Recife, PE, Brazil