The place of tracheostomy in tetanus neonatorum.

It has been shown that total curarization and intermittent positive pressure respiration (IPPR) improves the prognosis of newborn babies suffering from tetanus (Wright, Sykes, Jackson, Mann, and Adams, 1961), but facilities for its use are not always available. The physician responsible for treating a patient may have to turn to simpler means such as tracheostomy. Some consider this essential (Creech, Woodhall, and Ochsner, 1950; Smythe and Bull, 1961), while others have failed to show any advantage from its use (Wright, 1960; Veronesi, 1956), and many have pointed out its dangers (Liston, 1844; Durham, 1869; Reading, 1949, 1958; HughJones, 1959; Smythe, 1963; Plum and Dunning, 1956; Stothers, 1956; Forbes, Salmon, and Herweg, 1947). In the investigation reported here an attempt is made to evaluate the place of tracheostomy in neonatal tetanus.