The respiratory Intensive Care Unit was created at the Lagos University Teaching Hospital in 1963. Experience shows that mortality has been highest in neonates who had congenital anomalies, as well as in children under 2 years of age. The predominant cause of death was preventable respiratory failure. The incidence of mortality was 43 percent. This was related to several factors: (i) the severity of illness, types of illness and antecedent period of neglect; (ii) lack of a critical care medicine programme; (iii) insufficient skilled full-time intensive care personnel, including physicians, nurses, physiotherapists and paramedical specialists; (iv) the high incidence of infection in the Intensive Care Unit.