Incidence of Nasal Injury Among Neonates with Exposure to Nasal Continuous Positive Airway Pressure Treatment

Abstract

Introduction: Nasal continuous positive airway pressure (nCPAP) is a commonly used non-invasive respiratory support modality in neonates with respiratory failure. While effective, prolonged use of nCPAP is associated with nasal injuries ranging from mild erythema to severe necrosis, potentially increasing neonatal morbidity. Objective: To determine the incidence of nasal injury among neonates with respiratory failure receiving nCPAP therapy in the neonatal intensive care unit of Services Hospital, Lahore. Materials and Method: A descriptive cross-sectional study was conducted over six months (January to June 2024) on 100 neonates receiving nCPAP for at least 24 hours. Demographic and clinical data were recorded, and nasal injuries were assessed using the Nasal Injury Assessment Score Chart. Data analysis was performed using SPSS v25. Results: Nasal injury was observed in 39% of neonates. Most injuries were Grade 1 (61.5%), followed by Grade 2 (28.2%) and Grade 3 (10.3%). A significant association was found between duration of nCPAP ≥72 hours and the development of nasal injury (p < 0.001). Conclusion: The study reveals a high incidence of nasal injury linked to prolonged nCPAP use, highlighting the need for regular monitoring, preventive protocols, and staff training to reduce complications.