[Laryngeal edema after extubation. Do corticosteroids play a role in its prevention?]

The role of corticosteroids in the prevention of post-extubation laryngeal oedema was evaluated in a randomized study of 276 patients under mechanical ventilation. Fifty per cent of the patients received methylprednisolone 40 mg intramuscularly and intravenously. The nasotracheal tubes used had a large volume, low-pressure balloon. Laryngeal oedema, confirmed by laryngoscopy, occurred in six patients (2%), 4 of whom were in the corticosteroid-treated group, and required immediate reintubation in 4 cases. Thus, the incidence of laryngeal oedema was not modified by corticosteroids. Regular prescription of corticosteroids does not seem to be useful before extubation of patients intubated with large volume, low-pressure balloon tubes.