Dexamethasone reduces reintubation rate due to postextubation stridor in a high-risk paediatric population.
OBJECTIVE
To study the effect of dexamethasone on postextubation stridor (PS) incidence and reintubation rate due to PS in a high-risk paediatric intensive care population.


METHODS
All children aged between 4 wk and 6 y, who were intubated for at least 24 h and extubated between August 1999 and May 2002, were retrospectively included (n=60). Medical records of the included patients were studied; records of patients treated with dexamethasone prior to and following extubation (n=23) were compared with control patients who had not received prophylactic medication (n=37).


RESULTS
Nine patients in the control group developed significant postextubation stridor, necessitating nebulized epinephrine or glucocorticosteroids. In six of these children, reintubation as a result of postextubation stridor was indicated. None of the patients treated with dexamethasone developed severe postextubation stridor or required reintubation.


CONCLUSIONS
The risk of postextubation stridor is relatively high in the group of children aged between 4 wk and 6 y with intubation exceeding 24 h. We found dexamethasone to be effective in preventing reintubation due to postextubation stridor in this paediatric high-risk group.
Lukkassen
Ingrid M A
IM
Department of Paediatrics, St Antonius Hospital, Nieuwegein, The Netherlands. i.lukkassen@antonius.net
Hassing
Marre B F
MB
Markhorst
Dick G
DG
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D003440:Croup / Q000209:etiology / Q000517:prevention & control*; D003907:Dexamethasone / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008297:Male; D012135:Respiratory Sounds / Q000209:etiology; D012189:Retrospective Studies
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone