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Dexamethasone reduces reintubation rate due to postextubation stridor in a high-risk paediatric population

Ingrid M A Lukkassen1, Marre B F Hassing, Dick G Markhorst

  • 1Department of Paediatrics, St Antonius Hospital, Nieuwegein, The Netherlands. i.lukkassen@antonius.net

Acta Paediatrica (Oslo, Norway : 1992)
|December 24, 2005
PubMed

Insights

Dexamethasone effectively prevents postextubation stridor (PS) and reintubation in high-risk pediatric intensive care patients. This study found no severe PS or reintubations in children treated with dexamethasone.

Area of Science:

  • Pediatric Critical Care Medicine
  • Pharmacology

Background:

  • Postextubation stridor (PS) is a significant risk in pediatric intensive care.
  • Children aged 4 weeks to 6 years intubated for over 24 hours face a high risk of PS.

Purpose of the Study:

  • To evaluate the efficacy of dexamethasone in reducing the incidence of postextubation stridor.
  • To assess the impact of dexamethasone on reintubation rates due to PS in a high-risk pediatric population.

Main Methods:

  • Retrospective study of 60 pediatric patients (4 weeks to 6 years) intubated for at least 24 hours.
  • Comparison of 23 patients treated with dexamethasone (pre- and post-extubation) against 37 control patients.

Main Results:

  • Nine control patients developed significant PS requiring intervention (epinephrine or steroids).
  • Six control patients required reintubation due to PS.
  • No patients treated with dexamethasone experienced severe PS or required reintubation.

Conclusions:

  • Dexamethasone significantly reduces the risk of severe postextubation stridor.
  • Prophylactic dexamethasone is effective in preventing reintubation in high-risk pediatric patients.
Abstract

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