Ten preterm infants intubated 4-19 days for treatment of respiratory distress syndrome were given a cool racemic epinephrine aerosol after extubation to determine whether it had a beneficial effect on pulmonary function. Before and after the aerosol, tidal volume (VT), peak inspiratory flowrate (PIFR), peak expiratory flowrate, arterial blood gases, and vital signs were measured during quiet breathing. The temperature of inspired gas, with the micronebulizer in the incubator, decreased to 19-22°C by the end of the aerosol treatment. Two infants developed apnea during aerosol therapy, and the respiratory rate was significantly decreased (P<0.01) after the aerosol. VT and PIFR increased significantly (P < 0.05) after the aerosol, but there was no significant difference (P > 0.10) in arterial blood gas values or minute ventilation after the aerosol. Because of potential complications of aerosol therapy, we suggest that cool racemic epinephrine aerosols not be administered routinely to neonates after extubation. (Marshall TA, Pai S. The Effects of Racemic Epinephrine Aerosol Therapy after Prolonged Intubation in Preterm Infants. Respir Care 1984;29:138-143.
FarmatiO, QuinnJR, FennellRH. Exfoliative cytology of the intubated larynx in children. Can Anaesth Soc J1967;14:321–325.
2.
StrongRM, PassyV.Endotracheal intubation: Complications in neonates. Arch Otolaryngol1977;103:329–335.
3.
RascheRFH, KuhnsLR. Histopathologic changes in airway mucosa of infants after endotracheal intubation. Pediatrics1972;50:632–637.
4.
JoshiVV, MandaviaSG, SternL, WiglesworthFW. Acute lesions induced by endotracheal intubation. Am J Dis Child1972;124:646–649.
5.
SymchychPS, CadotteM.Squamous metaplasia and necrosis of the trachea complicating prolonged nasotracheal intubation of small newborn infants. J Pediatr1967;71:534–541.
6.
FanLL, FlynnJW, PathakDR, MaddenWA. Predictive value of stridor in detecting laryngeal injury in extubated neonates. Crit Care med1982;10:453–455.
7.
GoldsmithJP, KarotkinEH, eds. Assisted ventilation of the neonate. Philadelphia: WB Saunders, 1981:78–79.
8.
BradyJP, GregoryGA. Assisted ventilation. In: KlausMH, FanaroffAA, eds. Care of the high-risk neonate. Philadelphia: WB Saunders, 1979:219.
9.
AveryGB, ed. Neonatology: Pathophysiology and management of the newborn. Philadelphia: JB Lippincott, 1981:1222.
10.
DowningSE, LeeJC. Laryngeal chemosensitivity: A possible mechanism for sudden infant death. Pediatrics1975;55:640–649.
11.
HarnedHS, MyracleJ, FerreiroJ.Respiratory suppression and swallowing from introduction of fluids into the laryngeal region of the lamb. Pediatr Res1978;12:1003–1009.
12.
SasakiCT, SuzukiM.The respiratory mechanism of aerosol inhalation in the treatment of partial airway obstruction. Pediatrics1977;59:689–694.
13.
GoodenBA. Drowning and the diving reflex in man. Med J Aust1971;2:583–587.
14.
FrenchJW, MorganBC, GuntherothWG. Infant monkeys—A model for crib death. Am J Dis Child1972;123:480–484.
15.
MestyanJ, JaraiI, BataG, FeketeM.The significance of facial skin temperature in the chemical heat regulation of premature infants. Biol Neonate1964;7:243–254.
