{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:05:00Z","timestamp":1790193900772,"version":"4.1.0"},"reference-count":25,"publisher":"BMJ","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2010,5,7]]},"published-print":{"date-parts":[[2010,11]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate the incidence and severity of nasal trauma secondary to nasal continuous positive airway pressure (nCPAP) in neonates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Prospective observational study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Neonatal intensive care unit (NICU) of the University Hospital of Lausanne, Switzerland.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients<\/jats:title>\n                  <jats:p>All neonates admitted between January 2002 and December 2007 treated by nCPAP were eligible.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients' noses were monitored during nCPAP. Nasal trauma was reported into three stages: (I) persistent erythema; (II) superficial ulceration; and (III) necrosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>989 neonates were enrolled. Mean gestational age was 34 weeks (SD 4), mean birth weight 2142 g (SD 840). Nasal trauma was reported in 420 (42.5%) patients and it was of stage I, II and III in 371 (88.3%), 46 (11%) and 3 (0.7%) patients, respectively. Incidence and severity of trauma were inversely correlated with gestational age and birth weight. The risk of nasal trauma was greater in neonates &lt;32 weeks of gestational age (OR 2.48, 95% CI 1.59 to 3.86), weighing &lt;1500 g at birth (OR 2.28, 95% CI 1.43 to 3.64), treated &gt;5 days by nCPAP (OR 5.36, 95% CI 3.82 to 7.52), or staying &gt;14 days in the NICU (OR 1.67, 95% CI 1.22 to 2.28). Most cases of nasal trauma (90%) appeared during the first 6 days of nCPAP. Persistent visible scars were present in two cases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Nasal trauma is a frequent complication of nCPAP, especially in preterm neonates, but long-term cosmetic sequelae are very rare. This study provides a description of nasal trauma and proposes a simple staging system. This could serve as a basis to develop strategies of prevention and treatment of this iatrogenic event.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/adc.2009.179416","type":"journal-article","created":{"date-parts":[[2010,6,28]],"date-time":"2010-06-28T23:44:57Z","timestamp":1277768697000},"page":"F447-F451","source":"Crossref","is-referenced-by-count":180,"title":["Nasal trauma due to continuous positive airway pressure in neonates"],"prefix":"10.1136","volume":"95","author":[{"given":"C\u00e9line","family":"Fischer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Bertelle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Hohlfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margot","family":"Forcada-Guex","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne","family":"Stadelmann-Diaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Tolsa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2010,6,28]]},"reference":[{"key":"2025090514011153000_95.6.F447.1","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1056\/NEJM197106172842401","article-title":"Treatment of the idiopathic respiratory-distress syndrome with continuous positive airway pressure","volume":"284","author":"Gregory","year":"1971","journal-title":"N Engl J Med"},{"key":"2025090514011153000_95.6.F447.2","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1097\/00003246-197503000-00006","article-title":"A new device for CPAP by nasal route","volume":"3","author":"Wung","year":"1975","journal-title":"Crit Care Med"},{"key":"2025090514011153000_95.6.F447.3","doi-asserted-by":"publisher","DOI":"10.1136\/fn.81.2.F152"},{"key":"2025090514011153000_95.6.F447.4","first-page":"1887","article-title":"[Early application of CPAP in newborns with gestational age below 34 weeks lowers intubation rate and shortens oxygen therapy without altering mortality and morbidity]","volume":"130","author":"Joris","year":"2000","journal-title":"Schweiz Med Wochenschr"},{"key":"2025090514011153000_95.6.F447.5","doi-asserted-by":"crossref","unstructured":"Ho JJ Subramaniam P Henderson-Smart DJ . 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Devices and pressure sources for administration of nasal continuous positive airway pressure (NCPAP) in preterm neonates. Cochrane Database Syst Rev 2008;4:CD002977.","DOI":"10.1002\/14651858.CD002977.pub2"},{"key":"2025090514011153000_95.6.F447.23","unstructured":"Conner J De Klerk R . Care of the Infant on nCPAP. The Vermont Oxford Network Delivery Room Management Clinical Trial, 2008. http:\/\/www.vtoxford.org (accessed 8 November 2009)."},{"key":"2025090514011153000_95.6.F447.24","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1097\/01.ANC.0000317260.99072.ae","article-title":"Nursing Care Guidelines for prevention of nasal breakdown in neonates receiving nasal CPAP","volume":"8","author":"McCoskey","year":"2008","journal-title":"Adv Neonatal Care"},{"key":"2025090514011153000_95.6.F447.25","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1891\/0730-0832.28.1.13","article-title":"Prevention of nasal injuries secondary to NCPAP application in the ELBW infant","volume":"28","author":"Squires","year":"2009","journal-title":"Neonatal Netw"}],"container-title":["Archives of Disease in Childhood - Fetal and Neonatal Edition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/adc.2009.179416","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T21:01:19Z","timestamp":1757106079000},"score":1,"resource":{"primary":{"URL":"https:\/\/fn.bmj.com\/lookup\/doi\/10.1136\/adc.2009.179416"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,6,28]]},"references-count":25,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2010,10,26]]},"published-print":{"date-parts":[[2010,11]]}},"alternative-id":["10.1136\/adc.2009.179416"],"URL":"https:\/\/doi.org\/10.1136\/adc.2009.179416","relation":{},"ISSN":["1359-2998","1468-2052"],"issn-type":[{"value":"1359-2998","type":"print"},{"value":"1468-2052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,6,28]]}}}