Rıza Önder GÜNAYDIN, Şule YİĞİT, Alper AYKANAT, Hasan Tolga ÇELİK

Iatrogenic nasal synechiae in a premature newborn

Background. Nasal obstruction may cause short- and long-term problems such as respiratory distress, cyanosis, apnea, difficulty during feeding, and failure to thrive during the newborn period; since newborns are obligatory nasal breathers. Compression effect of the nasal cannulas and prongs used during respiratory support and nasal aspiration applications to clear the airways of secretions may result in nasal synechiae and acquired iatrogenic nasal obstruction. Case. In this case report, we present a premature newborn with nasal synechiae secondary to long-term nasal continuous positive airway pressure (nasal CPAP) applications and routine upper airway nursing care.Conclusion. Severe nasal damage may occur in premature newborns receiving prolonged nasal CPAP support. To prevent this upper airway care should be conducted as gently as possible in premature newborns.

PDF

___

1. Yurdakök M (ed). Mekanik ventilasyon. İçinde: Yurdakök M, Yiğit Ş, Çelik HT (ed).Yenidoğan Bakımında Hacettepe Uygulamaları (3. Basım). Ankara: Güneş Tıp Kitapevleri, 2019: 86-108.
2. Roehm CE, Lawrason A, Valdez TA. Nasal obstruction in newborn. In: Kountakis SE (ed). Encyclopedia of Otolaryngology, Head and Neck Surgery. Berlin, Heidelberg: Springer, 2013: 1746- 1757.
3. Yong SC, Chen SJ, Boo NY. Incidence of nasal trauma associated with nasal prong versus nasal mask during continuous positive airway pressure treatment in very low birthweight infants: a randomised control study. Arch Dis Child Fetal Neonatal Ed 2005; 90: F480-F483.
4. Gökdoğan O, İleri F. Nasal complications related with cpap treatment. ENT Updates 2018; 8: 133-138.
5. Jatana KR, Oplatek A, Stein M, Phillips G, Kang DR, Elmaraghy CA. Effects of nasal continuous positive airway pressure and cannula use in the neonatal intensive care unit setting. Arch Otolaryngol Head Neck Surg 2010; 136: 287-291.