Prevention of nasal injury in preterm infants during positive pressure ventilation: a systematic review of interface and dressing selection
Abstract Objective To conduct a systematic review and meta-analysis comparing the incidence of nasal injury in preterm infants undergoing continuous positive airway pressure (CPAP) therapy using nasal masks versus nasal prongs, and to explore the potential effects of prophylactic use of hydrocolloid...
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| Language: | English |
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BMC
2025-05-01
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| Series: | BMC Pediatrics |
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| Online Access: | https://doi.org/10.1186/s12887-025-05700-x |
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| author | Tian Gong Jia Li Yu Hua Yang Yu fan Tang Ao Huang Yuan xia Wang |
| author_facet | Tian Gong Jia Li Yu Hua Yang Yu fan Tang Ao Huang Yuan xia Wang |
| author_sort | Tian Gong |
| collection | DOAJ |
| description | Abstract Objective To conduct a systematic review and meta-analysis comparing the incidence of nasal injury in preterm infants undergoing continuous positive airway pressure (CPAP) therapy using nasal masks versus nasal prongs, and to explore the potential effects of prophylactic use of hydrocolloid dressings in reducing nasal injury in preterm infants. Methods On March 1, 2025, we searched the Web of Science, PubMed, Cochrane, and Embase databases for measures and strategies to prevent nasal injury in preterm infants undergoing positive pressure ventilation, and collected relevant randomized controlled trials. The Cochrane Risk of Bias Assessment Tool was used to evaluate the risk of bias in the literature, and the modified Jadad score was used to assess the quality of the studies. Key information was extracted, including the characteristics of the study subjects, interventions, incidence and severity of nasal injury, and failure rate of positive pressure ventilation. Results A total of 12 studies met the inclusion and exclusion criteria, including 1 low-quality study and 11 high-quality studies, with a total sample size of 1,271 participants. Eight studies compared the effects of nasal prongs and nasal masks, with 3 studies investigating the effects of alternating use of nasal prongs and masks. Four studies used hydrocolloid dressings. The results of the meta-analysis showed that the overall incidence of nasal injury was 0.62 (95% CI 0.45–0.87, P = 0.006) in the nasal mask group, 0.95 (95% CI 0.27–3.29, P = 0.093) in the alternating use group, and 0.40 (95% CI 0.30–0.53, P < 0.0001) in the hydrocolloid dressing group. Conclusion The incidence of nasal injury was lower in the nasal mask group compared to the nasal prong group. However, the effect of alternating use of nasal masks and prongs on reducing the incidence of nasal injury was not significant. Prophylactic use of hydrocolloid dressings had a significant effect on reducing the incidence of nasal injury in preterm infants. However, the limited number of existing studies and the small sample sizes of the included studies restricted the generalizability of the conclusions. Future research should further optimize the standardization of interventions and conduct multicenter, large-sample randomized controlled trials to promote continuous improvement in clinical nursing practice. |
| format | Article |
| id | doaj-art-fb1de9c62af54cc2a56f23a98e27101c |
| institution | Kabale University |
| issn | 1471-2431 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj-art-fb1de9c62af54cc2a56f23a98e27101c2025-08-20T03:47:16ZengBMCBMC Pediatrics1471-24312025-05-0125111210.1186/s12887-025-05700-xPrevention of nasal injury in preterm infants during positive pressure ventilation: a systematic review of interface and dressing selectionTian Gong0Jia Li Yu1Hua Yang2Yu fan Tang3Ao Huang4Yuan xia Wang5Department of Nursing, Second Clinical Hospital of North Sichuan Medical College, Nanchong Central HospitalDepartment of Nursing, Second Clinical Hospital of North Sichuan Medical College, Nanchong Central HospitalDepartment of Nursing, Second Clinical Hospital of North Sichuan Medical College, Nanchong Central HospitalBeijing Anzhen Hospital, Capital Medical University Nanchong Hospital Nanchong Central HospitalDepartment of Nursing, Second Clinical Hospital of North Sichuan Medical College, Nanchong Central HospitalZigong Fourth People’s Hospital, Affiliated to North Sichuan Medical CollegeAbstract Objective To conduct a systematic review and meta-analysis comparing the incidence of nasal injury in preterm infants undergoing continuous positive airway pressure (CPAP) therapy using nasal masks versus nasal prongs, and to explore the potential effects of prophylactic use of hydrocolloid dressings in reducing nasal injury in preterm infants. Methods On March 1, 2025, we searched the Web of Science, PubMed, Cochrane, and Embase databases for measures and strategies to prevent nasal injury in preterm infants undergoing positive pressure ventilation, and collected relevant randomized controlled trials. The Cochrane Risk of Bias Assessment Tool was used to evaluate the risk of bias in the literature, and the modified Jadad score was used to assess the quality of the studies. Key information was extracted, including the characteristics of the study subjects, interventions, incidence and severity of nasal injury, and failure rate of positive pressure ventilation. Results A total of 12 studies met the inclusion and exclusion criteria, including 1 low-quality study and 11 high-quality studies, with a total sample size of 1,271 participants. Eight studies compared the effects of nasal prongs and nasal masks, with 3 studies investigating the effects of alternating use of nasal prongs and masks. Four studies used hydrocolloid dressings. The results of the meta-analysis showed that the overall incidence of nasal injury was 0.62 (95% CI 0.45–0.87, P = 0.006) in the nasal mask group, 0.95 (95% CI 0.27–3.29, P = 0.093) in the alternating use group, and 0.40 (95% CI 0.30–0.53, P < 0.0001) in the hydrocolloid dressing group. Conclusion The incidence of nasal injury was lower in the nasal mask group compared to the nasal prong group. However, the effect of alternating use of nasal masks and prongs on reducing the incidence of nasal injury was not significant. Prophylactic use of hydrocolloid dressings had a significant effect on reducing the incidence of nasal injury in preterm infants. However, the limited number of existing studies and the small sample sizes of the included studies restricted the generalizability of the conclusions. Future research should further optimize the standardization of interventions and conduct multicenter, large-sample randomized controlled trials to promote continuous improvement in clinical nursing practice.https://doi.org/10.1186/s12887-025-05700-xNasal injuryPositive pressure ventilationPreterm infantsNewbornsNasal maskNasal prongs |
| spellingShingle | Tian Gong Jia Li Yu Hua Yang Yu fan Tang Ao Huang Yuan xia Wang Prevention of nasal injury in preterm infants during positive pressure ventilation: a systematic review of interface and dressing selection BMC Pediatrics Nasal injury Positive pressure ventilation Preterm infants Newborns Nasal mask Nasal prongs |
| title | Prevention of nasal injury in preterm infants during positive pressure ventilation: a systematic review of interface and dressing selection |
| title_full | Prevention of nasal injury in preterm infants during positive pressure ventilation: a systematic review of interface and dressing selection |
| title_fullStr | Prevention of nasal injury in preterm infants during positive pressure ventilation: a systematic review of interface and dressing selection |
| title_full_unstemmed | Prevention of nasal injury in preterm infants during positive pressure ventilation: a systematic review of interface and dressing selection |
| title_short | Prevention of nasal injury in preterm infants during positive pressure ventilation: a systematic review of interface and dressing selection |
| title_sort | prevention of nasal injury in preterm infants during positive pressure ventilation a systematic review of interface and dressing selection |
| topic | Nasal injury Positive pressure ventilation Preterm infants Newborns Nasal mask Nasal prongs |
| url | https://doi.org/10.1186/s12887-025-05700-x |
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