Abstract Objective: To evaluate the success rate of high-flow nasal cannula (HFNC) therapy using an adapted obsolete mechanical ventilator (MV), Optiflow™ and Vapotherm™ in newborns (NBs). Method: This was a retrospective observational study conducted in the neonatal intensive care unit (NICU). The sample comprised NBs who underwent HFNC therapy due to ventilatory dysfunction, for weaning from non-invasive ventilation (NIV), or post-extubation. The three groups, stratified according to gestational age (GA) and birth weight, and corrected GA and weight at the beginning of HFNC use, were as follows: Optiflow ™, Vapotherm ™, and obsolete Mechanical Ventilator (MV) adapted for high flow therapy. Subsequently, the NBs were divided into a success group (SG) and a failure group (FG). HFNC success was defined as a therapy duration exceeding 72 h. Results: A total of 209 NBs were evaluated, with 31.1 % using HFNC due to ventilatory dysfunction, 2.4 % after extubation, and 66.5 % after NIV weaning. HFNC success rate was observed in 90.9 % of the NBs, with no difference between equipment types (Vapotherm ™, Optiflow ™, and adapted VM). Conclusion: Different types of HFNC equipment are equally effective when used in neonatology for respiratory dysfunction, as a method of weaning from NIV and post-extubation. Adapted obsolete MV can be an alternative for HFCN therapy in resource-constrained settings. Objective highflow (HFNC MV, , NBs. . (NBs) Method NICU. NICU (NICU) dysfunction noninvasive non invasive NIV, (NIV) postextubation. postextubation post extubation. extubation post-extubation groups (GA use follows ™ (MV Subsequently SG (SG FG. FG (FG) 7 h Results 20 evaluated 311 31 1 31. 24 2 4 2. 665 66 5 66. 909 90 9 90. VM. VM VM) Conclusion resourceconstrained resource constrained settings (NBs (NICU (NIV (FG 3 6

ABSTRACT Objective The aim of this study was to evaluate the incidence of nasal injury in preterm newborns (NB) using the Neonatal Skin Condition Score within 7 days of noninvasive ventilation (NIV) and to compare the incidence of injury in NB weighing ≥1,000 g and those weighing <1,000 g at the time of initiation of NIV support. Methods This is a prospective, observational study carried out in a neonatal intensive care unit of a public hospital in Rio Grande do Sul from July 2016 to January 2021. Patients were stratified into two groups at the time of NIV initiation: group 1 (weight ≥1,000 g) and group 2 (weight <1,000 g). To assess the condition of nasal injury, a rating scale called the Neonatal Skin Condition Score was applied during the first seven consecutive days on NIV. Kaplan-Meier, log-rank test, and Cox proportional hazards regression were used to estimate the hazard ratio (HR) and 95% confidence interval (CI). Results In total, 184 NB were evaluated. Nasal injury was reported in 55 (30%) NB. The risk of nasal injury was 74% higher in group 2 (19/45) than in group 1 (36/139) (HR: 1.74; 95%CI 0.99–3.03, p=0.048). Conclusion The incidence of nasal injury in infants submitted to NIV by nasal mask was high, and the risk of this injury was greater in preterm infants weighing <1,000 g. (NB (NIV 1000 000 ≥1,00 <1,00 support prospective 201 2021 weight . KaplanMeier, KaplanMeier Kaplan Meier, Meier Kaplan-Meier logrank log rank test HR (HR 95 CI. CI (CI) total 18 evaluated 5 30% 30 (30% 74 19/45 1945 19 45 (19/45 36/139 36139 36 139 (36/139 1.74 174 95CI 099303 0 99 3 03 0.99–3.03 p=0.048. p0048 p p=0.048 048 p=0.048) high 100 00 ≥1,0 <1,0 20 202 9 (CI (30 19/4 194 4 (19/4 36/13 3613 13 (36/13 1.7 17 09930 0.99–3.0 p004 p=0.04 04 10 ≥1, <1, (3 19/ (19/ 36/1 361 (36/1 1. 0993 0.99–3. p00 p=0.0 ≥1 <1 ( (19 36/ (36/ 099 0.99–3 p0 p=0. ≥ < (1 (36 09 0.99– p=0 0.99 p= 0.9 0.

RESUMO Objetivo: Avaliar a incidência de lesão por pressão nasal em recém-nascidos (RN) pré-termos usando a Escala de Condição da Pele do Recém-Nascido durante sete dias de ventilação não invasiva (VNI) e comparar a incidência em RN ≥N.000 g e aqueles <1.000 g ao início da VNI. Métodos: Estudo observacional prospectivo realizado em uma Unidade Neonatal de Terapia Intensiva de um hospital público do Rio Grande do Sul, no período de julho de 2016 a janeiro de 2021. Os RN prematuros foram estratificados em dois grupos no momento do início da VNI: Grupo 1 (1u.000 g) e Grupo 2 (<1.000 g). O Neonatal Skin Condition Score foi aplicado durante os primeiros sete dias consecutivos de VNI. Curvas de Kaplan-Meier e teste Log-Rank e regressão de riscos proporcionais de Cox foram utilizados para estimar a razão de risco (HR) e intervalo de confiança (IC) de 95%. Resultados: Foram avaliados 184 RN. A lesão nasal foi relatada em 55 (30%) deles. O risco de lesão nasal foi 74% maior no Grupo 2 (n=19 em 45) do que no Grupo 1 (n=36 em 139) (HR=1,74; IC95% 0,99–3,03; p=0,048). Conclusão: A incidência de lesão nasal em neonatos submetidos à VNI por máscara nasal foi alta, e o risco dessa lesão foi maior em RN com peso <1.000 g. Objetivo recémnascidos recém nascidos (RN prétermos pré termos RecémNascido Recém Nascido (VNI N000 N 000 ≥N.00 1000 <1.00 Métodos Sul 201 2021 1u.000 1u000 u 1u (1u.00 (<1.00 . KaplanMeier Kaplan Meier LogRank Log Rank HR (HR IC (IC 95 95% Resultados 18 5 30% 30 (30% deles 74 n=19 n19 n 19 (n=1 45 n=36 n36 36 (n=3 139 HR=1,74 HR174 (HR=1,74 IC95 0,99–3,03 099303 0 99 3 03 p=0,048. p0048 p p=0,048 048 p=0,048) Conclusão alta N00 00 ≥N.0 100 <1.0 20 202 1u.00 1u00 (1u.0 (<1.0 9 (30 7 n=1 n1 (n= 4 n=3 n3 13 HR=1,7 HR17 (HR=1,7 IC9 0,99–3,0 09930 p004 p=0,04 04 N0 ≥N. 10 <1. 1u.0 1u0 (1u. (<1. (3 n= (n HR=1, HR1 (HR=1, 0,99–3, 0993 p00 p=0,0 ≥N <1 1u. (1u (<1 ( HR=1 (HR=1 0,99–3 099 p0 p=0, < (< HR= (HR= 0,99– 09 p=0 0,99 p= 0,9 0,

Resumo Introdução: Nas unidades de terapia neonatal, o tratamento fisioterapêutico visa ao cuidado integral do bebê. Objetivo: Descrever o perfil dos recém-nascidos (RNs) internados em uma UTI Neonatal. Métodos: Estudo retrospectivo documental com coleta de dados nos prontuários no período de julho de 2011 a julho de 2013. Pertencem à amostra os RNs que realizaram fisioterapia motora e respiratória. Os dados foram agrupados em cinco categorias de acordo com o peso ao nascimento (≤ 1.000 g, 1.001-1.500 g, 1.501-2.000 g, 2.001-2.500 g, ≥ 2.501 g). Resultados: De um total de 1.884 RNs internados na Unidade de Internação Neonatal do Hospital de Clínicas de Porto Alegre no período estipulado, 168 (13,9%) realizaram fisioterapia. Dos 168 RNs que realizaram fisioterapia, 137 nasceram neste hospital (81,5%) e 31 foram transferidos para o mesmo (18,5%); sendo que 17 desses bebês foram a óbito durante o período de internação neonatal (10,1%). Todos os RNs do grupo extremo baixo peso (≤ 1.000 g) necessitaram de ventilação pulmonar mecânica, 72,7% de ventilação não invasiva e 16,6% de ventilação mecânica de alta frequência. A ocorrência de pneumotórax no grupo de extremo baixo peso foi 13,8% e no grupo com peso de nascimento entre 1.001-1.500g foi de 16%. Conclusão: Bebês com baixo peso ao nascimento (< 2.500g) constituíram o perfil dos RNs que receberam atendimento de fisioterapia, sendo estes diretamente relacionados com maior incidência de óbito, pneumotórax, maior uso de ventilação pulmonar mecânica e ventilação não invasiva.

Abstract Introduction: In neonatal therapy units, physical therapy is directed toward integral baby care. Objective: To describe the profile of newborns (NBs) hospitalized in a Neonatal Intensive Care Unit (NICU). Methods: Retrospective documentary study with data collection from medical records from July 2011 to July 2013. The sample consisted of NBs who performed motor and respiratory therapy. Data were grouped into five categories according to birth weight (≤ 1000g, 1001-1500g, 1501-2000g, 2001-2500g, ≥ 2501g). Results: total of 1,884 newborns were admitted to the NICU within the stipulated period, 168 (13.9%) underwent physical therapy. Of the 168 NBs who underwent physical therapy, 137 were born in the hospital (81.5%) and 31 were transferred there (18.5%); 17 of these babies died during the neonatal hospital stay (10.1%). All newborns of the extremely low birth weight group (≤ 1000g) required mechanical ventilation, 72.7% non-invasive ventilation and 16.6% high-frequency oscillatory ventilation. The occurrence of pneumothorax in the extremely low birth weight group was 13.8% and 16% in the group with birth weight 1001-1500g. Conclusion: Infants with low birth weight (<2500g) constituted the profile of NBs who underwent physical therapy, which was directly related to higher incidence of death and pneumothorax, as well as increased use of mechanical and non-invasive ventilation.