Another complication of ribavirin therapy in a mechanically ventilated neonate

A critical incident is reported in which ribavirin administered from a small particle aerosol generator (SPAG) into a ventilator circuit became deposited around the humidifier temperature probe with the consequence that it became thermally insulated. This caused overheating of the humidifier and the potential for thermal injury to the respiratory tract. The circuit for aerosolized ribavirin administration is described and modifications suggested to avoid crystal precipitation within the circuit.