Abstract
To assess the pathologic changes in the airways of infants after endotracheal intubation, we examined histological sections of the airways of 19 infants who had been intubated for periods of time ranging from 15 minutes to 9 weeks and of 12 infants who had not been intubated. Fourteen of the 19 intubated infants had epithelial necrosis of the airway which none of the controls developed. Two kinds of mucosal necrosis were observed following intubation: focal necrosis in the larynx and extensive necrosis in the trachea. Anatomical differences between the trachea and the larynx may explain why necrosis is more extensive in the trachea and why complications occur most frequently in the subglottic area. The duration of the intubation was the most important single clinical factor related to damage of the airway when a properly fitted tube was used.
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