Prolonged Nasotracheal Intubation in Infants and Children

Abstract

THE ESTABLISHMENT and maintenance of a satisfactory artificial airway presents a major problem in the care of infants and children. Although tracheostomy is commonly used, it can produce serious complications at operation, during the period of intubation, and following decannulation.^1,2For 2½ years we have utilized nasotracheal tubes instead of tracheostomy in the management of a variety of airway and pulmonary problems. <h3>Materials and Methods</h3> A total of 116 children were intubated for a variety of problems which included: acute laryngotracheobronchitis, pneumonitis, status asthmaticus with respiratory failure, postoperative thoracotomy, and respiratory failure complicating nonrespiratory diseases such as encephalitis, renal failure, and exogenous obesity (Table 1). The mean age was 19 months with a range from 1 day to 14 years. Each child was seen by a pediatrician, an anesthesiologist, and an otolaryngologist. A consensus was reached that the airway problem could be handled best by nasotracheal intubation. <h3>Technique</h3> When