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July 19, 1965

Prolonged Respirator Use in Pulmonary Insufficiency of Newborn

Author Affiliations

From the departments of anesthesia (Drs. Thomas and Fletcher) and pediatrics (Drs. Sunshine, Schafer, and Klaus), Stanford University Medical Center, Palo Alto, Calif.

JAMA. 1965;193(3):183-190. doi:10.1001/jama.1965.03090030005001

Eighteen newborn infants who were moribund secondary to respiratory insufficiency were treated with prolonged mechanical breathing by an anesthetic endotracheal tube; 11 survived. On removal of the endotracheal tube laryngeal and tracheal obstruction did not develop. The longest period of successful respirator treatment was nine days. The birth weight of the smallest surviving infant was 2.2 lb (1,020 gm). Tracheal intubation with a soft plastic tube is quicker and simpler than tracheostomy, and even if maintained for many days, may be less traumatic. It deserves wider and probably earlier trial in the treatment of respiratory inadequacy of the newborn. Attention to detail is essential for airway preservation and for continuance of satisfactory ventilation. Nutrition is best managed by feeding through a gastrostomy tube.