Médecine et Réanimation du Nouveau - né, Service de Pédiatrie 2, Pôle Medico - Chirurgical Pédiatrique Hôpital de Hautepierre, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France.
INCI, UPR 3212, CNRS and University of Strasbourg, Strasbourg, France.
Acta Paediatr. 2023 Sep;112(9):1849-1859. doi: 10.1111/apa.16857. Epub 2023 Jun 6.
To issue practical recommendations regarding the optimal care of nasal skin when non-invasive ventilation support is used.
We performed a systematic search of PubMed to identify relevant papers published in English or French through December 2019. Different grades of evidence were evaluated.
Forty-eight eligible studies. The incidence in preterm infants was high. The lesions were more frequent for preterm infants born under 30 weeks of gestational age and/or below 1500 g. The lesion was most often located on the skin of the nose but could also be found on the intranasal mucous membranes or elsewhere on the face. Nasal injuries appear early after the beginning of non-invasive ventilation at a mean of 2-3 days for cutaneous lesions and eight or nine for intranasal lesions. The most effective strategies to prevent trauma are the use of a hydrocolloid at the beginning of the support ventilation, the preferential use of a mask and the rotation of ventilation interfaces.
Nasal injuries with continuous positive airway pressure treatment in preterm newborn infants were frequent and can induce pain, discomfort and sequelae. The immature skin of preterm newborn infants needs specific attention from trained caregivers and awareness by parents.
就使用无创通气支持时如何最佳护理鼻皮肤提出实用建议。
我们对 PubMed 进行了系统检索，以查找截至 2019 年 12 月发表的英文或法文相关论文。评估了不同等级的证据。
48 项合格的研究。早产儿的发病率很高。胎龄小于 30 周和/或体重低于 1500 克的早产儿更容易发生病变。病变最常见于鼻皮肤，但也可发生于鼻内黏膜或面部其他部位。鼻损伤在无创通气开始后平均 2-3 天（皮肤病变）和 8-9 天（鼻内病变）后出现。预防创伤最有效的策略是在开始支持通气时使用水胶体，优先使用面罩并旋转通气接口。
持续气道正压通气治疗早产儿鼻损伤频繁，可引起疼痛、不适和后遗症。早产儿不成熟的皮肤需要受过培训的护理人员的特别关注和家长的认识。
