Incidence of nasal trauma associated with nasal prong versus nasal mask during continuous positive airway pressure therapy in very low birth weight infants: a randomised control study

Sin-Chuen Yong ^1*, Seong-Joon Chen ¹ and Nem-Yun Boo ¹

¹ Universiti Kebangsaan Malaysia, Malaysia

^* To whom correspondence should be addressed. E-mail: scyong{at}mail.hukm.ukm.my.

Accepted 30 May 2005

Abstract

Objective:To compare the incidence of nasal trauma associated with prongs with that of mask during nasal continuous positive airway pressure (nCPAP) support in very low birth weight (VLBW, <1501g) infants.

Design:Randomised controlled clinical trial. Setting: Tertiary care university hospital, Department of Paediatrics, Kuala Lumpur, Malaysia.

Methods:All VLBW infants admitted to our neonatal intensive care unit between July 2001 and December 2003 who received nCPAP through the Infant Flow Driver were randomised to use either nasal prong or mask. The nasal cavity of these infants was inspected daily during the first week and then weekly until the infants were weaned off nCPAP.

Results:Of the 89 infants recruited, 41 were randomised into the mask group and 48 into the prong group. There was no significant difference in the incidence of nasal trauma between the two groups (p = 0.5). In infants put on nasal mask, the primary site of trauma was at the junction between the nasal septum and the philtrum. In infants put on nasal prongs, the walls of the nasal septum were the primary sites. Logistic regression analysis showed that the duration of nCPAP was the only significant risk factor associated with development of nasal injury, after controlling for birthweight, gestational age and nasal devices used (adjusted odds ratio: 1.04; 95% C.I.: 1.01, 1.07; p = 0.003).

Conclusion:Irrespective of the type of nasal devices used, nasal trauma is common during nCPAP therapy and should be removed as soon as an infant does not need it.

Keywords: continuous positive airway pressure, mask, prong, trauma, very low birth weight infants

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