ETCare: Safety and Preliminary Efficacy Trial

When babies are sick, or are born prematurely, they sometimes need an endotracheal (ET) tube to assist their breathing and/or a nasal canula. The investigators must periodically irrigate the ET tube to prevent them from being plugged up by secretions. The investigators also, due to the drying effects of nasal canula, periodically moisten the nasal passages of babies. Presently 0.9% saline is the solution being used for moistening of the ET tube, nose, as well as oral cares will infant is not eating. However, scientists have recently learned that saline can destroy the body's natural antibacterial properties in the windpipe, nose, and mouth. The investigators have developed a new solution to be used in place of saline for endotracheal (ET), nasal, and oral cares. The investigators' new solution is patterned after the natural fluid in the windpipe, nose, and mouth. Study Hypothesis:

1. 1.Patients who receive ETCare will have no increase in adverse events related to its administration, compared with 0.9% saline.
2. 2.Patients who receive ETCare will have a lower proportion of tracheal aspirates where pathogens are reported.
3. 3.Patients who receive ETCare will have a lower proportion of tracheal aspirates where leukocytes are reported.
4. 4.Patients who receive ETCare will have fewer (risk-adjusted) days of supplemental oxygen.