Rotating nasal masks with nasal prongs reduces the incidence of moderate to severe nasal injury in preterm infants supported by noninvasive ventilation

ABSTRACT Objective: To investigate the association between noninvasive ventilation delivery devices and the incidence of nasal septum injury in preterm infants. Methods: This retrospective singlecenter cohort study included preterm infants supported by noninvasive ventilation. The incidence of nasal injury was compared among three groups according to the noninvasive ventilation delivery device (G1 - nasal mask; G2 - binasal prongs; and G3, rotation of nasal mask with prongs). Nasal injury was classified according to the National Pressure Ulcer Advisory Panel as stages 1 - 4. Multivariate regression analyses were performed to estimate relative risks to identify possible predictors associated with medical device-related injuries. Results: Among the 300 infants included in the study, the incidence of medical device-related injuries in the rotating group was significantly lower than that in the continuous mask or prong groups (n = 68; 40.48%; p value摘要 研究目的：探讨无创通气（noninvasive ventilation）输送装置与早产儿鼻中隔损伤（nasal septum injury）发生率的关联。 研究方法：本回顾性单中心队列（retrospective single-center cohort）研究纳入接受无创通气支持的早产儿，根据所使用的无创通气输送装置分为三组：G1组为鼻面罩组；G2组为双鼻鼻塞（binasal prongs）组；G3组为鼻面罩与鼻塞轮换使用组。鼻腔损伤参照美国国家压疮咨询委员会（National Pressure Ulcer Advisory Panel, NPUAP）的分期标准划分为1~4期。采用多变量回归分析（multivariate regression analysis）估算相对风险（relative risk），以识别与医疗器械相关损伤（medical device-related injuries）相关的潜在预测因素。 研究结果：本研究共纳入300例早产儿，轮换使用组的医疗器械相关损伤发生率显著低于持续使用面罩或鼻塞组（轮换组样本量n=68，发生率40.48%；P值