Use of Oxygen Cannulas in Extremely Low Birthweight Infants is Associated with Mucosal Trauma and Bleeding, and Possibly with Coagulase-negative Staphylococcal Sepsis

Objective: We studied the association between the use of oxygen cannulas (OCs) and (1) nasal bleeding and (2) coagulase-negative staphylococcal sepsis (CNSS).

Study Design: Review of care sheets, with chi(2) or sign-test group comparisons.

Results: Infants treated with OCs were suctioned more frequently (2.6 vs 1.3 times per day, p<0.001), and had more bloody nasal secretions (34.6% vs 4.6%, p<0.05) that increased with increasing OC days. By 10 days, 90% of infants had experienced bloody secretions.CNSS occurred less often in infants treated with oxyhoods than those on OC or CPAP (1 of 13, 8%, vs 10 of 44, 23%), but the difference was not significant. Eight of the 10 CNSS episodes clustered within 3 and 7 days of starting CPAP or cannula treatments.

Conclusion: OC use in extremely low birthweight infants is associated with nasal mucosal injury and bleeding. Studies are needed to see if use of OCs is a risk factor for CNSS.