Despite progress in neonatal medicine and the development of new methods of treatment such as surfactant administration and new modalities of ventilation, mortality remains significant among newborn infants weighing less than 500 gram. Neurodevelopmental outcome of infants born before 26 weeks gestation is perceived as very poor. As the result of recent reports, there have been calls for limitation of medical care for these infants. We report of only 4 infants weighing less than 400 grams, who have survived. Two of these infants developed respiratory failure and required aggressive conventional mechanical ventilation. We report on the survival of an infant delivered before the completion of 26 weeks gestation period and weighing 300 grams. The infant was ventilated by high frequency oscillatory ventilation for respiratory distress syndrome. She is the second smallest infant reported in the medical literature.
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