Dexamethasone in the prevention of postextubation stridor in children.

Abstract

To assess whether there is any advantage in the use of corticosteroid to prevent postextubation stridor in children, we conducted a prospective, randomized, double-blind trial of dexamethasone versus saline solution. The patients were evaluated and then randomly selected to receive either dexamethasone or saline solution according to a stratification based on risk factors for postextubation stridor: age, duration of intubation, upper airway trauma, circulatory compromise, and tracheitis. Dexamethasone, 0.5 mg/kg, was given every 6 hours for a total of six doses beginning 6 to 12 hours before and continuing after endotracheal extubation in a pediatric intensive care setting. There was no statistical difference in incidence of postextubation stridor in the two groups; 23 of 77 children in the placebo group and 16 of 76 in the dexamethasone group had stridor requiring therapy (p = 0.21). We conclude that the routine use of corticosteroids for the prevention of postextubation stridor during uncomplicated pediatric intensive care airway management is unwarranted.

• Authors: D W Tellez, A G Galvis, S A Storgion, H N Amer, M Hoseyni, T W Deakers
• Journal: The Journal of pediatrics (J Pediatr) Vol. 118 Issue 2 Pg. 289-94 (Feb 1991) ISSN: 0022-3476 [Print] United States
• PMID: 1993963 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Dexamethasone

Topics

• Child
• Child, Preschool
• Dexamethasone (therapeutic use)
• Double-Blind Method
• Humans
• Infant
• Intensive Care Units, Pediatric
• Intubation, Intratracheal (adverse effects)
• Laryngeal Edema (prevention & control)
• Prospective Studies
• Respiratory Sounds (etiology)
• Risk Factors