A modified nasopharyngeal tube to relieve high upper airway obstruction

Infants with high upper airway obstruction (UAO) are managed with a variety of techniques to relieve their UAO. Among these techniques, the least inva sive and safest is the nasopharyngeal tube (NPT). However, the traditional NPT is not always satisfactory, and tracheostomies need to be done. We rece ntly described a modified NPT technique that, in contrast to the traditiona l tube, does not add airway dead space and resistance, is easy to use, is w ell-tolerated, has proven highly successful, and allows the simultaneous us e of oxygen nasal prongs. This modified NPT has many advantages over the tr aditional NPT as a temporary management of high UAO that resolves with grow th of the infant. This report highlights the respiratory care of 10 infants with high UAO (Pierre Robin syndrome, Down syndrome, Goldenhar syndrome, i solated microngathia, and idiopathic hypotonia) who were managed with a mod ified NPT. The modified NPT described potentially reduces the need for surg ical intervention to relieve high UAO in infants. (C) 2000 Wiley-Liss, Inc.