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November 1972

Acute Lesions Induced by Endotracheal IntubationOccurrence in the Upper Respiratory Tract of Newborn Infants With Respiratory Distress Syndrome

Author Affiliations

From the departments of pathology (Drs. Joshi, Mandavia, and Wiglesworth) and newborn medicine (Dr. Stern), the Montreal Children's Hospital and the McGill University-Montreal Children's Hospital Research Institute, Montreal. Dr. Stern is a Queen Elizabeth II scientist for research in diseases of children. Dr. Joshi is now with Medical College of Virginia, Richmond, Va.

Am J Dis Child. 1972;124(5):646-649. doi:10.1001/archpedi.1972.02110170024003

Clinical charts, autopsy records, and slides of the larynx, trachea, and bronchi in 172 cases of newborn infants with respiratory distress syndrome (RDS) were reviewed for acute lesions induced by endotracheal intubation. Mild lesions (mucosal or submucosal necrosis) were seen in 63.3% and relatively severe lesions showing inflammatory changes in 15.8% of the cases. No lesions were seen in the remaining cases. Vocal cords with or without the subglottic region of larynx and trachea were the commonest lesion sites. Lesion severity was directly related to duration of intubation and subsequent bacterial infection. In seven (4.3%) cases Pseudomonas pneumonia with or without septicemia extending from acute diffuse laryngotracheobronchitis was a major factor in infant death. Comparable focal lesions in RDS survivors may result in residual permanent damage to upper respiratory tract.