Yong et al identified traumatic lesions to the nose in infants receiving continuous positive airway pressure therapy. Nasal trauma may occur with either the use of nasal prongs or a nasal mask. The authors are from Hospital Universiti Kebangsaan Malaysia in Kuala Lumpur.


Nasal lesions that may occur during CPAP:

(1) erythema (redness)

(2) bleeding

(3) crusting

(4) excoriation

(5) stenosis (narrowing) of the passage


Location of nasal injuries:

(1) with nasal prongs: walls of the nasal septum

(2) with mask: junction between the nasal septum and philtrum


Risk factors for nasal trauma:

(1) prematurity (with delicate skin and little subcutaneous fat)

(2) other causes for friable skin and mucosa

(3) prolonged placement causing persistent pressure

(4) improper application (straps to tight, incorrect location, etc)

(5) excessive rubbing back and forth


Techniques to reduce the risk:

(1) frequent examination of the nares for early signs of injury

(2) ongoing education and training

(3) proper placement

(4) discontinue use as soon as possible


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