8.9 NASAL INJURIES IN PRETERM INFANTS ASSOCIATED WITH CONTINUOUS POSITIVE-AIRWAYS PRESSURE

E. A. Alsop¹, J. Cooke¹, S. Gupta². ¹Neonatal Directorate, the James Cook University Hospital, Middlesbrough, UK, ²Neonatal Directorate, University Hospital of North Tees, Stockton, UK

Background: Nasal trauma is a recognised complication of nasal continuous positive-airways pressure (CPAP) therapy, but its prevalence and severity has not been compared in controlled trials.

Methods: Preterm infants <30 weeks gestation and/or <1500 g at birth, randomly assigned to infant flow driver CPAP (IFD) or bubble CPAP (BCPAP) were followed to assess the incidence and severity of nasal injury. Nasal injury data on all babies were recorded prospectively on a nasal injury scoring chart devised for this study. The severity of nasal injury was graded as mild (1–4), moderate (5–8) or severe (⩾9). Data were analyzed using t-tests and χ² tests.

Results: Records were obtained on 85 infants (IFD 46, BCPAP 39). There was no difference in the gestational age (27.7 weeks in IFD versus 27.6 weeks in BCPAP) and birthweight (1046 g in IFD versus 1024 g in BCPAP) between the two study groups. Half of the study infants sustained moderate (31.8%) to severe (24.7%) nasal injuries. This was similar in the two groups (54.3% on IFD versus 59.0% on BCPAP; p = 0.668). The time of worst nasal injury was similar (IFD 4.2 ± 3.9 days versus BCPAP 4.5 ± 5.1 days, p = 0.813).

Conclusions: Nasal injury was equally common in babies receiving CPAP with either IFD or BCPAP devices and requires further intervention to reduce its frequency and severity.