RU2411920C1 - Nasal cannula-protector for newborn babies - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medical instruments and can be used for prevention of traumatic injuries from the side of anterior parts of nose at the background of carrying out method of respiratory support CPAP in newborn babies, including prematurely born babies. Nasal cannula-protector for newborn babies contains attachable case with two working tubes on lateral surface and detachable external nose protector in form of plate from silicon material from 1×1 cm to 1×1.5 cm in size. Plate has holes for installation on meddle sections of working tubes, made with external diametres reduced on 0.1-0.5 mm with respect to external diametres of end sections. Distance between central axes of working tubes equals 5-15 mm. At the ends of attachable case two installation supports are placed. Installation supports are oriented at obtuse angles to lateral surface of attachable case, which has working tubes.

EFFECT: ensuring prevention of nasal septum necrosis, infection of anterior nose parts, external nose deformations, formation of synechias in nasal cavity due to sparing impact of cannula on soft tissues of newborn baby, protection of external nose, as well as adequate respiratory support due to prevention of cannula-protector displacement.

3 cl, 1 dwg

Description

The invention relates to medical instruments and can be used to prevent traumatic injuries from the front of the nose against the background of the CPAP method of respiratory support (constant positive airway pressure) in newborns, including premature babies.

Known nasal cannula containing a connecting body and two curved working tubes placed on its side surface (US 7024235 B2, 04/04/2006).

The disadvantages of the cannula US 7024235 are the lack of funds necessary to protect the external nose, and the angular bends of its working tubes, which make it difficult to install the cannula in newborns.

Closer to the proposed invention is a nasal cannula US 7565907 B2, 07/28/2009, containing a connecting housing and two working tubes that are placed on the side surface of the connecting housing and have smooth bends.

The disadvantage of the nasal cannula US 7565907 should include the lack of funds on the connecting body, excluding its displacement during treatment, as well as the lack of funds necessary to protect the external nose.

The objective of the invention is to develop a specialized cannula for newborns that do not have the disadvantages of similar devices.

The technical result of the invention consists in the prevention of necrosis of the nasal septum, infection of the anterior sections of the nose, deformations of the external nose, the formation of synechia in the nasal cavity due to the gentle action of the cannula on the soft tissues of the newborn, protection of the external nose, as well as providing adequate respiratory support by preventing cannula displacement -protector.

The invention is expressed in the combination of essential features, in which the nasal cannula protector for newborns, containing a connecting casing with two working tubes on the side surface, differs from the closest analogue in that it additionally contains a removable protector of the external nose, made in the form of a plate of hydrocolloid material with sizes from 1 × 1 cm to 1 × 1.5 cm, and the plate has holes for installation in the middle sections of the working tubes made with outer diameters reduced by 0.1- 0.5 mm with respect to the outer diameters of the end sections, while the distance between the central axes of the working tubes is 5-15 mm, and at the ends of the connecting case there are two mounting supports oriented at obtuse angles to the side surface with the working tubes.

In special cases of its implementation or use, the nasal cannula may contain a plate made of Comfeel Coloplast hydrocolloid material, and the plate may have a sticky surface with a paper coating.

The influence of the features of the invention on its technical result lies in the fact that the removable protector of the external nose, made in the form of a plate of hydrocolloid material with sizes from 1 × 1 cm to 1 × 1.5 cm, and with holes for installation in the middle sections of the working tubes, made with outer diameters reduced by 0.1-0.5 mm relative to the outer diameters of the end sections, allows you to fix the plate on the working tubes due to slight deformation of the holes and / or tubes and it is easy to replace the tread during treatment, with this plate sizes in the range from 1 × 1 cm to 1 × 1.5 cm are most suitable for newborns. Placing the working tubes at a distance of 5-15 mm between their central axes provides an individual selection of a protector cannula for each newborn. The mounting supports, each of which is oriented at an obtuse angle to the lateral surface with the working tubes, make it possible to eliminate cannula displacement during treatment with minimal impact on the soft tissues of the external nose.

The implementation of the plate of the hydrocolloid material Comfeel Coloplast is preferred, but other materials can also be used. The sticky surface of the plate ensures its fixation on the tissues, and the paper coating retains the properties of the sticky surface.

The invention is illustrated in the drawing, which gives a General view of the nasal cannula for newborns with a connecting body, shown separately from the removable tread.

The nasal cannula protector for newborns contains a connecting body 1 with two working tubes 2 and 3 on the side surface and a removable outer nose protector in the form of a plate 4 of hydrocolloid material with sizes from 1 × 1 cm to 1 × 1.5 cm. Plate 4 has holes 5 and 6 for installation in the middle sections of the working tubes 2 and 3, made with outer diameters reduced by 0.1-0.5 mm with respect to the outer diameters of the end sections. The distance between the central axes of the working tubes 2 and 3 is 5-15 mm. At the ends of the connecting housing 1 there are two mounting supports 7 and 8. The mounting supports 7 and 8 are oriented at obtuse angles to the side surface of the connecting housing 1 having working tubes 2 and 3.

In special cases of its implementation or use, the nasal cannula protector may contain a plate 4 made of Comfeel Coloplast hydrocolloid material.

To use the nasal cannula protector for newborns, the skin is first prepared for applying a hydrocolloid protector made in the form of a plate 4 with holes 5 and 6. For this, the back, wings and tip of the nose are lubricated with sterile water and dried with a dry gauze swab.

Then, carefully, with minimal pressure on the bottle, 1-2 drops of saline or Aqua Maris solution are instilled into each nasal passage.

When making a silicone protector from Comfeel Coloplast hydrocolloid material, the paper coating of plate 4 is peeled off and it is fixed to the skin with a sticky side.

Through the holes 5 and 6 of the plate 4, carefully insert two working tubes 2 and 3 so that the plate 4 is located in the middle sections of the tubes. Since the distance between the axes of the working tubes 2 and 3 is 5-15 mm, the cannula is installed with minimal impact on the patient, while the outer diameters of the middle sections of the working tubes 2 and 3, reduced by 0.1-0.5 mm relative to the outer the diameters of their end sections, allow for the relationship of the housing 1 and the plate 4.

Then, the connecting housing 1 is connected to the CPAP apparatus and the necessary parameters are set.

When impregnating a plate 4 made, for example, from Comfeel Coloplast material, detachable from the nasal cavity or wound surface and changing its color to the edges from brown to milky white, plate 4 is replaced (once a day). The ratio of the outer diameters of the middle and end sections of the working tubes 2 and 3 does not prevent their separation from the removable tread 4 and does not require additional attention and effort.

Clinical example 1.

Child T. 1st day of life, II from twins, from a mother 27 years old, with a complicated somatic history - a concussion, not complicated by an obstetric-gynecological history. Pregnancy I, real. Pregnancy: I half - toxicosis. II half - the threat of interruption. At 27 weeks - feto - fetal blood transfusion syndrome. Polyhydramnios of II fetus, oligohydramnios of I fetus. Operative labor at 28 weeks of bichorial, biamniotic twins, amniotic fluid - without features. Weight at birth is 810 g, height is 32 cm, head circumference is 23 cm, chest circumference is 19 cm, with an Apgar score of 6/7 points.

The condition of the baby at birth is severe. Was in the intensive care unit for 31 days. The main diagnosis: Congenital interstitial pneumonia. BPD (bronchopulmonary dysplasia). Concomitant: Cerebral ischemia of the II degree. Neonatal cramps. Apnea Syndrome. TDM (transient myocardial dysfunction). NK II Art. Anemia of prematurity. ZVUR (intrauterine growth retardation) III Art. Prematurity 28-29 weeks. II of twins. CPAP (continuous positive airway pressure) therapy from birth - 21 days. CPAP with a constant flow - 7 days. CPAP with variable flow - 14 days.

During CPAP therapy, the authors proposed the nasal protector for babies proposed by the authors, containing a removable outer nose protector in the form of a 1 × 1 cm Comfeel Coloplast hydrocolloid material plate and 5 mm between the central axes of the working tubes of the connecting case.

The skin of the back, wings and tip of the nose was treated with sterile water and a dry gauze swab, then 1-2 ml of physiological saline or “Aqua Maris” solution was instilled into each nasal passage.

After that, the paper coating of the plate was separated and it was fixed on the skin with the sticky side. Two working tubes were carefully inserted through the holes of the plate so that the plate was located in the middle sections of the tubes.

Changes in the skin of the nose were monitored every 6 hours with fixing the results in the observation map.

When the plate was soaked with nasal cavity discharge when its color changed to the edges from brown to milky white, the plate was replaced (usually once a day).

Dynamics of the state of soft tissues of the anterior parts of the nose against the background of CPAP therapy on a daily basis: 1, 2, 3 days - unchanged, from 4 days the appearance of mild hyperemia, hyperemia persisted until the end of CPAP therapy, there were no destructive injuries from the soft tissues of the nose noted.

No complications in the form of necrosis of the nasal septum, infection of the anterior sections of the nose were noted. The child is provided with adequate respiratory support due to the prevention of cannula displacement.

Clinical example 2.

Child F. 1st day of life, from a mother 38 years old with a burdened somatic history - varicose veins, with a burdened obstetric history - chronic bilateral salpingoophoritis, from the third pregnancy. In the first trimester - ARVI, in the second-third trimester - gestational edema, from the first birth at 29 weeks. Low water. Amniotic fluid - without features. Birth weight is 1100 g, height is 38 cm, chest circumference is 26 cm, head circumference is 27 cm. Apgar score is 6/7 points. From birth to CPAP therapy. Primary diagnosis: SDR (respiratory distress syndrome). Congenital pneumonia. Concomitant: Cerebral Ischemia II Art. Edema syndrome. Prematurity 29 weeks. CPAP therapy - 8 days.

During CPAP therapy, the authors proposed a nasal protector for babies proposed by the authors, containing a removable outer nose protector in the form of a Comfeel Coloplast hydrocolloid material plate with a size of 1 × 1.5 cm and a distance of 15 mm between the central axes of the working tubes of the connecting case. The skin of the back, wings and tip of the nose was treated with sterile water and a dry gauze swab, then 1-2 ml of physiological saline or “Aqua Maris” solution was instilled into each nasal passage.

Then the paper coating of the plate was separated and it was fixed on the skin with a sticky side. Two working tubes were carefully inserted through the holes of the plate so that the plate was located in the middle sections of the tubes.

Changes in the skin of the nose were monitored every 6 hours and the results were recorded in the observation map.

When the plate was soaked with detachable material from the nasal cavity when the color changed to the edges from brown to milky white, the plate was replaced (usually once a day).

The dynamics of the soft tissues of the anterior sections of the nose against the background of CPAP therapy for days: 1, 2 days - without pathological changes. 3 days - hyperemia. Before the end of CPAP therapy, destructive damage from the soft tissues of the nose was not detected. No complications in the form of necrosis of the nasal septum, infection of the anterior sections of the nose were noted. The child is provided with adequate respiratory support due to the prevention of cannula displacement.

Claims (3)

1. Nasal cannula protector for newborns, containing a connecting body with two working tubes on the side surface, characterized in that it further comprises a removable protector of the external nose, made in the form of a plate of hydrocolloid material with sizes from 1 × 1 cm to 1 × 1, 5 cm, and the plate has holes for installation on the middle sections of the working tubes made with outer diameters reduced by 0.1-0.5 mm, relative to the outer diameters of the end sections, while the distance between the central E is equal to the working tubes 5-15 mm, and two mounting supports, oriented at an obtuse angle to the side surface with the working tubing disposed at the ends of a connector housing. 2. The protector cannula according to claim 1, characterized in that the plate is made of Comfeel Coloplast hydrocolloid material. 3. The cannula protector according to claim 2, characterized in that the plate has a sticky surface with a paper coating.

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