The The Frequency and Severity of Nasal Trauma Secondary to Nasal Continuous Positive Airway Pressure in Neonates

Ahmed Khalil Ibrahim; Noor Sameer Yahya; Ghaith Wadhah Hamdoon

doi:10.54133/ajms.v10i1.2712

Authors

Ahmed Khalil Ibrahim Department of Pediatrics, College of Medicine, Ninevah University, Mosul, Iraq https://orcid.org/0000-0001-7729-1852
Noor Sameer Yahya Department of Pediatrics, College of Medicine, University of Mosul, Mosul, Iraq https://orcid.org/0000-0001-7563-3871
Ghaith Wadhah Hamdoon Department of Pediatrics, College of Medicine, University of Mosul, Mosul, Iraq https://orcid.org/0009-0000-8304-3660

DOI:

https://doi.org/10.54133/ajms.v10i1.2712

Keywords:

NCPAP, Nasal trauma , Neonates , Pressure injury , Risk Factors , Severity progression

Abstract

Background: Nasal trauma is a well-recognized iatrogenic complication in neonates with respiratory distress using nasal continuous positive airway pressure (NCPAP). The severity of nasal injury ranges from mild erythema to necrosis. Objective: to determine the frequency of nasal trauma and risk factors associated with the severity progression secondary to NCPAP. Methods: A prospective observational study was conducted in Mosul City. Newborns who received NCPAP were included to assess nasal trauma and its severity. Univariate and multivariate logistic regression were used to identify factors associated with the nasal trauma. The Mann-Whitney U test was used to compare continuous variables and nasal trauma stages, and the effect sizes were reported. Results: The incidence of nasal trauma was 46.2%. In univariate analysis, factors associated with increased odds of trauma were lower gestational age (OR=3.367; p<0.001), lower birth weight (OR=2.923; p<0.001), and NICU stay ≥7 days (OR=2.507; p=0.049), while the duration of NCPAP was not statistically significant (OR=1.341; p=0.515). However, in the multivariate analysis, none of the factors emerged as an independent predictor. NICU stay ≥7 days in the Mann-Whitney U test was the only significant predictor of severity progression (p=0.034), with a medium to large effect size. Conclusions: Nasal trauma is a common and significant complication of NCPAP in neonates. Severity is usually mild, but moderate and severe cases do occur. Lower gestational age, lower birth weight, and longer NCPAP duration are risk factors for nasal injury, but prolonged NICU stay appeared to be a strong predictor for nasal trauma progression.

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