PROLONGED NASOTRACHEAL INTUBATION: A Review of its Development in a Paediatric Hospital

Abstract

The value of prolonged nasotracheal intubation of certain babies and children with reversible respiratory inadequacy has become recognized as a result of the postoperative management of neonatal babies. In certain situations, the procedure may be used as an alternative to tracheostomy and may be effective when tracheostomy might be ill-advised. Its value lies in: (i) The ease and rapidity of performance by those used to passing endotracheal tubes, (ii) The effective reduction of deadspace when this is critical, (iii) Its usefulness in allowing control of moderate secretions, (iv) The ability to bypass upper respiratory tract obstructions, particularly when the nature of the obstructions may be such as to render tracheostomy hazardous, (v) The effective use of controlled ventilation when this is indicated, particularly in the baby, (vi) The avoidance of some of the hazards of tracheostomy, particularly in the neonatal baby.