Evidence map›Paper›PMID 28914355›Full record

Trial reportEuropean journal of pediatrics2017

Nasal injury and comfort with jet versus bubble continuous positive airway pressure delivery systems in preterm infants with respiratory distress.

Jafar Khan, Venkataseshan Sundaram, Srinivas Murki, Anuj Bhatti, Shiv Sajan Saini, Praveen Kumar

Registry-linked trialAbstract readComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in European journal of pediatrics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04293601 (Pressure Injuries' Prevention in Newborn Infants Admitted to NICU Receiving Noninvasive Respiratory Support With Nasal Continuous Positive Airway Pressure), which is not on this map. Cited by 19 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 3 pooled it
2.2field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04293601 nacompletednot on this mapstarted 2019, after this paper: background citation

Pressure Injuries' Prevention in Newborn Infants Admitted to NICU Receiving Noninvasive Respiratory Support With Nasal Continuous Positive Airway Pressure (NCPAP)

TypeinterventionalSponsorFondazione IRCCS Ca' Granda, Ospedale Maggiore PoliclinicoRan2019 to 2022Enrolled280ConditionsNewborn, Pressure InjuryArmsinterventional nursing care, Standard nursing care
3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 38 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Neonatal Pain, Agitation, and Sedation Scale's use, reliability, and validity: a systematic review.Journal of perinatology : official journal of the California Perinatal Association · 2020
    Pooled it
  4. Trial
  5. Trial
  6. Trial
  7. Trial
  8. Low humidification temperature during non-invasive ventilation in late preterm and term neonates: a randomized controlled trial.Journal of perinatology : official journal of the California Perinatal Association · 2026
    Article
  9. Article
  10. Reporting nasal pressure injuries in neonates receiving non-invasive ventilation: a scoping review.Journal of perinatology : official journal of the California Perinatal Association · 2024
    Article
  11. Article
  12. Review
  13. Article
  14. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Jafar KhanDepartment of Neonatology, Fernandez Hospital, Hyderabad, India.
Venkataseshan SundaramDivision of Neonatology, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India. venkatpgi@gmail.com.
Srinivas MurkiDepartment of Neonatology, Fernandez Hospital, Hyderabad, India.
Anuj BhattiDivision of Neonatology, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Shiv Sajan SainiDivision of Neonatology, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Praveen KumarDivision of Neonatology, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Post Graduate Institute of Medical Education and Research · INFernandez Hospital · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Nasal injuries with use of nasal continuous positive airway pressure (CPAP) range from blanching of nasal tip to septal necrosis and septal drop. This analysis was done in preterm neonates of < 34-week gestation, who received nasal CPAP as primary support as part of a randomized trial comparing Jet device with Bubble device for delivery of CPAP, both through nasal prongs of different structure, make and fixation methods. Nasal injury was assessed using a validated nasal injury score. Out of 170 neonates enrolled, 103 (61%) had nasal injuries; moderate and severe injuries were observed in 18 (11%) and 8 (5%) infants, respectively. Septum was the most common site injured. The incidence and severity of nasal injury were significantly lesser in Jet group compared to Bubble group [RR 0.6 (95% C.I. 0.5-0.8); p < 0.001]. Similarly, neonates in Jet group had lesser average [median (IQR): 3 (3,4) vs. 4 [8, 14]; p = 0.04] as well as peak N-PASS pain scores [median (IQR): 4 [8, 14] vs. 5 [13, 16]; p = 0.01] in comparison to Bubble group. However, Jet group neonates had significantly more common prong displacements.

conclusionBubble CPAP device with its nasal interface had higher and more serious incidence of nasal injuries in comparison to Jet CPAP device. What is known: • Nasal injuries are becoming increasingly common with use of nasal CPAP low gestational age, low birth weight, longer use of CPAP and longer NICU stay are risk factors for such injuries • Validated nasal injury scores have been created for assessment of nasal trauma in neonates What is new: • Bubble device with its interface had higher and more serious incidence of nasal injuries in comparison to Jet device • Even though pain assessed by N-PASS was less with Jet device, prong displacements were more frequent with its system.

Indexed as

Continuous Positive Airway PressureFemaleHumansInfant, NewbornInfant, PrematureMaleNoseRespiratory Distress Syndrome, NewbornTreatment OutcomeBubble CPAPJet CPAPNasal injuryPainPreterm

Identifiers

PMID28914355
OpenAlexW2755066551

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.