Posture in the management of esophageal atresia: Variations on a theme by Dr. E. B. D. Neuhauser☆

Abstract Following a suggestion made by Dr. E. B. D. Neuhauser many years ago, an investigation was carried out to ascertain why infants with esophageal atresia tend to suffer from collapse of the right upper lobe after thoracotomy. It was found that the neonate's bronchial tree does not differ anatomically to any marked degree from that of adults but that when the infant is lying flat on his back, contrast medium instilled into the trachea will invariably run first into the right upper lobe. Pathological considerations and clinical experience have shown that nursing these infants in the prone head-down position will prevent aspiration to a very marked degree and a special frame has been constructed to facilitate the nursing procedure.