An Integrative Review of Skin Breakdown in the Preterm Infant Associated with Nasal Continuous Positive Airway Pressure
| Autor: | W. Thomas Bass, Katherine M. Newnam, Jeanne Salyer, Jacqueline M. McGrath, Nancy Jallo, Tracy Estes |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Critical Care Nursing Risk Assessment Skin Diseases Pediatrics Skin breakdown Sepsis Nursing care Maternity and Midwifery medicine Humans Continuous positive airway pressure Respiratory system Intensive care medicine Monitoring Physiologic Skin Respiratory Distress Syndrome Newborn Continuous Positive Airway Pressure business.industry Incidence (epidemiology) Data synthesis Infant Newborn Gestational age medicine.disease Nasal Mucosa Treatment Outcome Female business Infant Premature |
| Zdroj: | Journal of Obstetric, Gynecologic & Neonatal Nursing. 42:508-516 |
| ISSN: | 0884-2175 |
| DOI: | 10.1111/1552-6909.12233 |
| Popis: | Objective To identify factors associated with skin injury during nasal continuous positive airway pressure (NCPAP) and describe differences in frequency, severity, and type of skin injuries when comparing nasal interfaces used during NCPAP in the preterm infant. Data Sources Scientific databases were searched using provided key terms and yielded 113 articles. Study Selection Forty‐six articles were included in this integrative review: six case studies, 22 with identified aim of examining skin and nasal injury during NCPAP; 18 included skin care considerations during NCPAP. Data Extraction Studies were categorized into four themes: types of nasal injuries; associated risk factors that increase incidence of injury; differences between NCPAP devices and/or nasal interface and corresponding rate and severity of nasal injury; and recommended prevention strategies to reduce iatrogenic cutaneous injury. Data Synthesis Skin injury was a common theme during neonatal NCPAP with skin breakdown rates of 20% to 60%. Increased skin injury risk was associated with smaller infant size, gestational age, and duration of therapy. Nursing care strategies to improve skin integrity during NCPAP had little supportive evidence. Nursing practice is varied with reportedly little standardized care during NCPAP therapy. Recommendations for specific care strategies to reduce skin injury during NCPAP were supported by limited experimental studies. Conclusions Risk factors during NCPAP include nasal injury and trauma secondary to tight‐fitting nasal interfaces necessary to provide continuous distending pressure for respiratory stability. Identifying strategies to reduce skin breakdown will support noninvasive treatment success, reduce reintubation rates, reduce sepsis, reduce patient discomfort, and improve developmental outcomes during NCPAP use. |
| Databáze: | OpenAIRE |
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