Nasotracheal intubation versus tracheostomy for intermittent positive pressure ventilation in neonatal tetanus

Fifty-two neonates with tetanus who required muscle paralysis and IPPV were managed alternatively with naso-tracheal intubation or tracheostomy. The complications of the two techniques were compared. Planned extubation caused less problems in the intubated than in the tracheostomized children, and secondary infection occurred less often. Accidental extubation, however, was a significant hazard in the intubated child.