nCPAP-induced Nasal Injury: Case Series and Brief Literature Review

Paola Cavicchioli, Valeria Silecchia, Enrico Valerio, Margherita Fantinato, Irene Giovannini, Ramon Grimalt, Mario Cutrone


nCPAP-induced nose skin injury is a common issue in NICUs all over the world. Damage may vary from simple hyperemia in the region of application of nasal cannulae up to complete destruction of the columellar region. We here report a case series of three patients displaying various grades of nasal damage, ranging from soft hyperemia to ulcerative lesions, up to complete columellar breakdown. Not only lesions with loss of substance are documented in literature; cases of post-discharge nasal vestibular stenosis and nasal synechiae obstruction are also reported. Risk factors for nCPAP-induced nasal injury include low birth weight, low gestational age, and increased time on nCPAP. Good clinical practices to prevent and treat nCPAP-induced skin damage are here briefly reviewed; strong efforts must be spent in NICU personnel education in order to enhance awareness about this topic and ensure a correct prevention.

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