Corticosteroids for the prevention and treatment of post-extubation stridor in neonates, children and adults

Prevalence of Reintubation Within 24 Hours of Extubation in Bronchiolitis: Retrospective Cohort Study Using the Virtual Pediatric Systems Database*

“…However, the VPS database has been used for many retrospective observational studies of critically ill children and uses strict quality control measures to reduce data entry errors (33)(34)(35). Third, we were not able to evaluate cointerventions such as sedation to facilitate compliance with NIPPV (36,37), use of corticosteroids to reduce extubation failure (38)(39)(40), occurrence of accidental/unplanned extubation (41), and others that may have impacted our findings. Fourth, we did not calculate a sample size a priori, and it is possible that our analyses may be underpowered.…”

Prevalence of Reintubation Within 24 Hours of Extubation in Bronchiolitis: Retrospective Cohort Study Using the Virtual Pediatric Systems Database*

“…However, the VPS database has been used for many retrospective observational studies of critically ill children and uses strict quality control measures to reduce data entry errors (33)(34)(35). Third, we were not able to evaluate cointerventions such as sedation to facilitate compliance with NIPPV (36,37), use of corticosteroids to reduce extubation failure (38)(39)(40), occurrence of accidental/unplanned extubation (41), and others that may have impacted our findings. Fourth, we did not calculate a sample size a priori, and it is possible that our analyses may be underpowered.…”

Defining sedation-related adverse events in the pediatric intensive care unit

“…However, excessive movement of the ETT within the airway is thought to precipitate airway trauma in the agitated pediatric patient. The reported pediatric incidence of post-extubation stridor requiring treatment ranges from 15% to 41% 72-74 . The frequency of pediatric reintubation for stridor ranges from 2% to 52% 72-77 .…”

“…The reported pediatric incidence of post-extubation stridor requiring treatment ranges from 15% to 41% 72-74 . The frequency of pediatric reintubation for stridor ranges from 2% to 52% 72-77 . Other variables related to stridor included the number of racemic epinephrine treatments 73,76-80 , use of a helium-oxygen gas mixture 73 , and stridor requiring some form of intervention 74,77 .…”

Predictors and outcomes of extubation failures in a pediatric intensive care unit: A retrospective study

“…Laryngeal edema post-extubation is more common in pediatric than adult patients, primarily because of differences in respiratory tract anatomy; an occurrence rate of 4–37% has been reported in earlier studies with varying population demographics. 6 , 23 , 31 , 32 Several studies have explored the effectiveness and efficacy of corticosteroids such as dexamethasone in treating UAO, laryngeal edema, and post-extubation stridor, through anti-inflammatory effects. However, the results of the prophylactic use of dexamethasone have not been standardized, because of contradictory reports among clinical studies.…”

Prevalence of Reintubation Within 24 Hours of Extubation in Bronchiolitis: Retrospective Cohort Study Using the Virtual Pediatric Systems Database*

“…However, the VPS database has been used for many retrospective observational studies of critically ill children and uses strict quality control measures to reduce data entry errors (33)(34)(35). Third, we were not able to evaluate cointerventions such as sedation to facilitate compliance with NIPPV (36,37), use of corticosteroids to reduce extubation failure (38)(39)(40), occurrence of accidental/unplanned extubation (41), and others that may have impacted our findings. Fourth, we did not calculate a sample size a priori, and it is possible that our analyses may be underpowered.…”

Defining sedation-related adverse events in the pediatric intensive care unit

“…However, excessive movement of the ETT within the airway is thought to precipitate airway trauma in the agitated pediatric patient. The reported pediatric incidence of post-extubation stridor requiring treatment ranges from 15% to 41% 72-74 . The frequency of pediatric reintubation for stridor ranges from 2% to 52% 72-77 .…”

“…The reported pediatric incidence of post-extubation stridor requiring treatment ranges from 15% to 41% 72-74 . The frequency of pediatric reintubation for stridor ranges from 2% to 52% 72-77 . Other variables related to stridor included the number of racemic epinephrine treatments 73,76-80 , use of a helium-oxygen gas mixture 73 , and stridor requiring some form of intervention 74,77 .…”

Predictors and outcomes of extubation failures in a pediatric intensive care unit: A retrospective study

“…Laryngeal edema post-extubation is more common in pediatric than adult patients, primarily because of differences in respiratory tract anatomy; an occurrence rate of 4–37% has been reported in earlier studies with varying population demographics. 6 , 23 , 31 , 32 Several studies have explored the effectiveness and efficacy of corticosteroids such as dexamethasone in treating UAO, laryngeal edema, and post-extubation stridor, through anti-inflammatory effects. However, the results of the prophylactic use of dexamethasone have not been standardized, because of contradictory reports among clinical studies.…”

Prevalence of Reintubation Within 24 Hours of Extubation in Bronchiolitis: Retrospective Cohort Study Using the Virtual Pediatric Systems Database*

“…However, the VPS database has been used for many retrospective observational studies of critically ill children and uses strict quality control measures to reduce data entry errors (33)(34)(35). Third, we were not able to evaluate cointerventions such as sedation to facilitate compliance with NIPPV (36,37), use of corticosteroids to reduce extubation failure (38)(39)(40), occurrence of accidental/unplanned extubation (41), and others that may have impacted our findings. Fourth, we did not calculate a sample size a priori, and it is possible that our analyses may be underpowered.…”

Defining sedation-related adverse events in the pediatric intensive care unit

“…However, excessive movement of the ETT within the airway is thought to precipitate airway trauma in the agitated pediatric patient. The reported pediatric incidence of post-extubation stridor requiring treatment ranges from 15% to 41% 72-74 . The frequency of pediatric reintubation for stridor ranges from 2% to 52% 72-77 .…”

“…The reported pediatric incidence of post-extubation stridor requiring treatment ranges from 15% to 41% 72-74 . The frequency of pediatric reintubation for stridor ranges from 2% to 52% 72-77 . Other variables related to stridor included the number of racemic epinephrine treatments 73,76-80 , use of a helium-oxygen gas mixture 73 , and stridor requiring some form of intervention 74,77 .…”

Predictors and outcomes of extubation failures in a pediatric intensive care unit: A retrospective study

“…Laryngeal edema post-extubation is more common in pediatric than adult patients, primarily because of differences in respiratory tract anatomy; an occurrence rate of 4–37% has been reported in earlier studies with varying population demographics. 6 , 23 , 31 , 32 Several studies have explored the effectiveness and efficacy of corticosteroids such as dexamethasone in treating UAO, laryngeal edema, and post-extubation stridor, through anti-inflammatory effects. However, the results of the prophylactic use of dexamethasone have not been standardized, because of contradictory reports among clinical studies.…”