PT  - JOURNAL ARTICLE
AU  - Jagjit Singh Dalal
AU  - Sanketh Kumar Ajmera
AU  - Kanika Prajapat
AU  - Tanushree Sahoo
AU  - Chander Prakash Yadav
AU  - P V Madhusudhan Rao
AU  - Alok Thakar
AU  - Anu Thukral
AU  - Mari Jeeva Sankar
AU  - Ashok Kumar Deorari
AU  - Ramesh Agarwal
TI  - Discrepancy in the physical dimensions of nose and continuous positive airway pressure (CPAP) interface: a possible reason for high rates of nasal injury in Indian neonates
AID  - 10.1136/bmjinnov-2019-000372
DP  - 2021 Jan 01
TA  - BMJ Innovations
PG  - 33--39
VI  - 7
IP  - 1
4099  - http://innovations.bmj.com/content/7/1/33.short
4100  - http://innovations.bmj.com/content/7/1/33.full
SO  - BMJ Innov2021 Jan 01; 7
AB  - Background Properly fitting continuous positive airway pressure (CPAP) interface is critical to the efficacy and safety of nasal CPAP therapy in preterm. Unfortunately, there is a perception that CPAP interfaces being used in Indian neonatal intensive care units do not fit well and cause a high rate of nasal injury.Objectives To determine the nasal anthropometric dimensions in preterm (<35 weeks) Indian neonates and compare them with those of commercially available CPAP interfaces.Methods In this cross-sectional study, relevant anterior nasal parameters were measured by three dimensional imaging in 32 preterm newborn (26+0–34+6 weeks) and compared with commercially available 17 short binasal CPAP prongs of multiple sizes made by five manufacturers. Dimensions for best-suited interfaces were generated for Indian neonates.Results The mean (SD) gestation and birth weight of enrolled neonates were 30.6 (3.0) weeks and 1338 (575) g, respectively. The inter prong distance was narrower than the upper bound of the 95% CI of the columellar width in Hudson type CPAP interfaces in <1250 g weight category with discrepancy in measurement varying from 0.2 to 0.5 mm and 0.9–1.4 mm at midpoint and base of columella, respectively. Similarly, the lower bound of 95% CI of the distance between the lateral walls of the nostrils was narrower than the width of the prongs by 1–3 mm.Conclusions There is mismatch between nasal prongs and nose dimension of Indian neonates resulting in possible erosion of columella and distension of nostrils.