Respiratory distress syndrome and tracheoesophageal fistula: management with high-frequency ventilation.

An 1180-g infant with esophageal atresia and tracheoesophageal fistula developed life-threatening respiratory distress syndrome. Conventional mechanical ventilation resulted in gastric perforation and pneumoperitoneum. High-frequency ventilation stabilized the infant, permitting distal occlusion of the esophagus with a Silastic band. Fistula ligation was subsequently performed under more optimal physiologic conditions.