Iatrogenic epithelial change caused by endotracheal intubation of neonates

Tracheae of 20 neonates were obtained at postmortem examination. All neonates had been intubated for between 4 h and 105 days. The tracheal epithelial lining was examined by both light and scanning electron microscopy. Five tracheae which had never been intubated served as controls. All of these showed ciliation throughout their length. Those neonates who had been intubated showed epithelial change which ranged from a simple deciliation to a full stratified squamous epithelium. The degree of change was broadly related to the duration of intubation.