Neonatal nasotracheal intubation: An evaluation

Abstract

A retrospective review of 100 surviving infants, all requiring nasotracheal intubation in the neonatal period for greater than 24 hr. was performed to assess the morbidity of this form of airway management. Seventy infants needed only one intubation, 22 were intubated twice and 8 infants required 3 intubations. No infant had evidence of laryngeal or tracheal sequelae, either in the immediate newborn period or on follow‐up. Nasotracheal intubation by an experienced practitioner with appropriate tube fixation and toilet coupled with the use of low pressure ventilation and a consistent extubation routine will result in very low long‐term tracheal morbidity in the neonate.

Clinical Analysis of Laryngeal Trauma Secondary to Intubation

“…Histological analyses of the lesions produced by intubation have been made with accuracy both quantitatively and qualitatively (Burns et al 1970, Hilding 1971, Loeser et al 1978. The respiratory function of the larynx and trachea is the sole physiological activity to have undergone similar scrutiny following intubation (Stewart et al 1980, Strong & Passy 1977.…”

Accidental extubations during respiratory management in a children’s hospital

“…Stewart et a1. 3 reported that neonatal nasal intuba.tion is certainly superior with respect to the stability of the endotracheal tube, though our neonatologists still prefer the oral route possibly because they are anxious about infection to nasal septum and eustachian tube when respiratory support is required for a long time. Furthermore some institutions insisted orotracheal intubation is a safe method of maintaining prolonged tracheal intubation in premature and term newborn infants.…”