Ocena występowania powikłań miejscowych w wyniku zastosowania różnych technik nieinwazyjnej wentylacji u noworodków

Abstract

ObjectivesThe assessment of the appearance of local complications associated with the use of different non-invasive ventilation techniques in neonates. Materials and MethodsThe study was conducted in a group of 103 neonates, in whom non-invasive ventilation was administered using different techniques. In these subjects non-invasive respiratory CPAP (conventional system) support was used with single lumen nasopharyngeal cannula, double lumen Hudson type short cannula as well as the Baby Flow and the Infant Flow systems for administration of all modes of ventilation. Data were collected based on own observations and on medical records of the neonates treated in the Neonatal Intensive Care Department of the Medical University of Warsaw between 21.01.2008 and 06.05.2009. ResultsThe average duration of the different non-invasive ventilation techniques was 7.77 days (min. 1 day, max. 32 days). Skin complications were mainly concerned with the nasal structures and were of varying intensity: from transient ischemia, erythema, dermal abrasion, bleeding, necrosis and narrowing of the lumen of the nasal passages (edema of the nasal mucosa). Complications associated with the use of the Baby Flow and Infant Flow systems were dependent upon the type of nasal tip. In cases when a mask was used, the most frequent type of complication concerned lesions of the base of the nose (34 cases) and lesions of the upper labial sulcus (13 cases). Complications involving the nasal septum (8 cases) were associated with the use of short double lumen nasal cannulae with the Baby Flow and Infant Flow systems as well as with Hudson type cannulae (2 cases). Necrosis of the nasal septum was associated with the use of Hudson type cannulae in two neonates. ConclusionsThe number of complications affecting the skin associated with the use of non-invasive ventilation is dependent on the maturity of the neonate, the body mass and the duration of ventilation. Complications affecting the skin are markedly more frequent in those cases when masks are used compared with the use of short double lumen cannulae, and they mainly affect the base of the nose. Undoubtedly, the majority of complications are transient in nature.