ABSTRACT
Both the fields of neonatology and technology have made great advances over the last few decades. Because of the routine use of surfactant and steroids, it is now rare to see an infant dependent on a ventilator for lung disease alone, and it is neither unusual nor unsafe to leave an infant on a ventilator with an endotracheal tube in place for months on end. Most infants who need a tracheostomy do so because of an inadequate airway. These infants otherwise are ready to go home or to a facility for technologically dependent children, but still require ventilatory assistance.
