When Conventional Mechanical Ventilation Fails

  • Jay P. Goldsmith
  • Rodney B. Steiner
  • Robert M. Arensman


The modern era of assisting neonatal ventilation dates back approximately 3 decades. During this time, numerous advances in diagnosis, ventilatory equipment, technique, adjunctive pharmacologic therapy, nutritional support, and understanding and treatment of cardiovascular aspects of respiratory pathology have helped to dramatically reduce morbidity and mortality from neonatal respiratory failure. Initial experience with neonatal assisted ventilation was far from encouraging in the treatment of respiratory distress syndrome (RDS) and other causes of ventilatory failure. The first major series reported only one long-term survivor in 18 infants affected with RDS [1]. Another early series reported that only 7 of 20 babies survived [2]. In a large group of ventilated infants (n = 196) treated at Stanford University from 1962 to 1969 for various causes of respiratory failure, only 33% survived [3]. Swyer’s [4] survey of intensive care units in 1969 revealed only a 39% survival of infants with RDS who required assisted ventilation. Results were so poor in the first decade of experience with conventional mechanical ventilation that Behrman [5] concluded in a 1970 editorial that there was no proof that assisted ventilation was superior to oxygen therapy alone in premature infants and mechanical ventilation was not “the established treatment for hyaline membrane disease.”


Extracorporeal Membrane Oxygenation Congenital Diaphragmatic Hernia Assisted Ventilation Pulmonary Hypoplasia Conventional Mechanical Ventilation 
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Copyright information

© Springer-Verlag New York Inc. 1989

Authors and Affiliations

  • Jay P. Goldsmith
  • Rodney B. Steiner
  • Robert M. Arensman

There are no affiliations available

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