Non-invasive respiratory support and preterm infants: The crucial role of nurse management

Abstract

Premature delivery is often a failure of transition to create an early Functional Residual Capacity (FRC) and therefore preterm infants frequently need a respiratory support. To reduce the occurrence or severity of respiratory distress, neonatologists have to plan an optimal respiratory strategy from the first breath and within the “working-team” the nurses play a crucial role. Since duration of mechanical ventilation via the ET seems related to Bronchopulmonary Dysplasia (BPD), clinicians are increasingly using non invasive respiratory supports (e.g. n-CPAP and Non-Invasive Ventilation-
NIV) to try to protect the preterm infant’s lungs. Nurses are essential fundamental in choosing the best fitted devices and interfaces (e.g. hat, prongs), in protecting skin from infections, in taking a continuous care of the neonate to avoid nasal trauma, in maintaining and protecting parental bonding. The success of non-invasive respiratory support improves with staff experience and it is recognized that there is an urgent need for continuous education of nursing staff in preventing failure of non-invasive respiratory support.