Edema of the Nasal Mucosa Complicating Treatment of Respiratory Distress Syndrome

We describe an infant with acquired edema of the nasal mucosa that interfered with the effectiveness of the treatment with continuous positive airway pressure (CPAP), which he was receiving by the nasal route. Report of a Case .—A male infant, born at 36 weeks' gestation to a diabetic mother, weighed 3,070 gm. Respiratory distress appeared at 30 minutes of age. Oxygen was administered at a concentration of 30%. Initial arterial blood values were pH, 7.13; Pco 2 , 67 mm Hg; Po 2 , 35 mm Hg. Chest roentgenograms showed findings characteristic of the respiratory distress syndrome with obliteration of the heart borders. By 24 hours of age the inspired oxygen concentration Fio 2 had been increased to 65% and the Pao 2 was 40 mm Hg. Continuous positive airway pressure was begun using nasal prongs. 1 Prior to this time, nasopharyngeal suction had been accomplished through each nostril. Transient improvement occurred, but at 48 hours, with an