RVJMayo

I'm belatedly catching up on old emails during retirement. I once happened to be present in the delivery suite caring for a newly born preemie when unexpectedly a term baby was born with immediate severe respiratory distress. Initially I thought the baby might have tracheal stenosis, but when even a 2.5 ET wouldn't pass I suspected tracheal atresia. Assuming there was a potential for a fistula I intentionally intubated the esophagus (with a 3.5 ET as I recall) and the saturations promptly improved. We were able to maintain conventional ventilation via the fistula, and brought the baby to the OR for bronchoscopy and ENT evaluation. Unfortunately there were other severe anomalies including cardiac so the baby didn't survive but ventilation through an esophageal intubation bought us significant time.

Babies with cleft palate who require intubation can pose a challenge to visualize with the usual Miller blade; so having an LMA could be helpful. I didn't know that a size 0.5 was available, "bimalc" do you have details of brand and model? Thanks Bob Johnson