SURGICAL MANAGEMENT OF RESPIRATORY EMERGENCIES DURING THE FIRST FEW WEEKS OF LIFE

Abstract

SINCE respiratory embarrassment in the newborn is a frequently encountered condition which may merit consideration and treatment from a surgical standpoint, it is our purpose to discuss 3 illustrative instances in which radical surgical measures were necessary in the treatment of infants whose dyspnea and cyanosis noted at birth failed to improve. Mitchell-Nelson's Textbook of Pediatrics¹ states that almost one half of the deaths of newborn infants are due to respiratory failure. Morgan and Brown² listed nine accidents during labor which produced cyanosis of the newborn. Only one of these, aspiration of amniotic fluid, directly concerns the surgeon. This aspiration may cause bronchial obstruction with attendant emphysema or atelectasis, for which surgical treatment may be necessary. Since atelectasis is always present at birth, the degree and rate of expansion of the lungs in the newly born child may be significant. Wasson³ made roentgenograms of the chest at