The problem of detubating an infant with a tracheostomy

摘要

In 1964, Smythe described a series of infants with tracheotomy for an unusual indication: effective treatment of tetanus neonatorum with relaxation and intermittent positive-pressure ventilation. The condition occurred secondary to the Zulu practice of coating the cut umbilicus of the newborn with dung. Ventilation was required for approximately 4 weeks. Iatrogenic changes in the trachea caused by the tracheotomy tube in turn led to difficulties in decan-nulation, requiring prior endoscopic surgery.