Prevention of subglottic stenosis in neonatal ventilation.
Mechanical ventilation of the newborn is now widely used in neonatal intensive care. The oro-tracheal route of intubation is simpler, but for long-term ventilation has been considered unstable. A method of fixation of oro-tracheal tubes is described which overcomes this instability. Five hundred consecutive ventilated infants were intubated by the oro-tracheal route and the tube was fixed by the method described. Of the 500 ventilated infants, 213 died without being extubated. Of the 287 survivors, 44 developed a degree of post-extubation stridor. No surviving infant developed clinical evidence of subglottic stenosis and in almost 200 postmortem examinations laryngeal narrowing was not identified. The method of oro-tracheal fixation described is stable and may reduce the incidence of subglottic stenosis.
I A
IA
Laing
D L
DL
Cowan
G M
GM
Ballantine
R
R
Hume
D001507:Beclomethasone / Q000627:therapeutic use; D001835:Body Weight; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods*; D007829:Laryngostenosis / Q000209:etiology / Q000517:prevention & control*; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods*; D012135:Respiratory Sounds / Q000209:etiology
D001507:Beclomethasone