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December 18, 1987

Care of the Infant With Prolonged Ventilator Dependency

JAMA. 1987;258(23):3430-3431. doi:10.1001/jama.1987.03400230090039

The improved survival of critically ill infants has resulted in a rapid increase in the number of patients who require prolonged respiratory support. As a result of this, neonatal and pediatric intensive care units are frequently faced with the dilemma of having to allocate a portion of their limited resources to the care of infants who remain ventilator dependent for extended periods.

Despite the magnitude of this problem, it has seldom been addressed in the medical literature. This may reflect the frustration inherent in this situation for care givers who are accustomed to dealing with acute rather than chronic illnesses. The article from Schreiner and collaborators1 in this issue of The Journal describes many facets of this problem and raises several medical, ethical, and social issues.

The first and most important question that needs to be considered is whether different treatment strategies for infants with acute respiratory failure can influence