Starch in Lungs of Newborns

Sir.—Over ten years ago in the Journal (1970;119:218-220), D. W. Dain et al called attention to starch in the lungs of newborns after the use of positive pressure ventilation. Since then, to our knowledge no reference has been made to that publication. However, the problem is a continuing one, as we have observed in a neonatal intensive care unit in which endotracheal suction is routinely performed with Bard-Parker Suction Kits that contain one sterile glove and a suction catheter. The glove and catheter come packed in the same envelope and the glove is powdered with cornstarch. Because the catheter is not packaged separately, it too becomes powdered; also, because there is only one glove, it is used without prior washings, so that starch is directly applied to the catheter tip. This introduces starch granules into the lungs of infants.

We reviewed 28 cases of premature infants from Texas Children's