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A Brief History of Invasive and Noninvasive Neonatal Ventilation

The first form of assisted ventilation for neonates was intermittent positive-pressure ventilation provided via an ETT, which became widespread in the late 1960s and early 1970s. George Gregory and associates[4] were the first to describe the use of CPAP in neonates in 1971, a therapy they developed because of the high mortality observed in infants weighing less than 1500 g, particularly those requiring assisted ventilation in the first 24 hours of life. The first series of 20 “severely ill” infants with RDS were treated with CPAP delivered predominantly via an ETT. In an attempt to avoid the complications of endotracheal intubation, other interfaces were developed, including a pressurized plastic bag[5] and a tight-fitting face mask.[6] Two infants in the initial Gregory series were managed in a pressure chamber around the infant's head.[4] In 1976, Ahlström and colleagues[7]described the use of a face chamber providing pressures up to …