Using Steroids to Prevent Airway Problems After Extubation
Author Information
Author(s): Fan Tao, Wang Gang, Mao Bing, Xiong Zeyu, Zhang Yu, Liu Xuemei, Wang Lei, Yang Sai
Primary Institution: West China Hospital, Sichuan University
Hypothesis
Are steroids effective in preventing laryngeal oedema after extubation and reducing the need for reintubation in critically ill adults?
Conclusion
Prophylactic administration of steroids in multidose regimens before planned extubation reduces the incidence of laryngeal oedema after extubation and the consequent reintubation rate in adults, with few adverse events.
Supporting Evidence
- Steroids decreased the odds ratio for laryngeal oedema to 0.38.
- Steroids reduced the need for reintubation with an odds ratio of 0.29.
- Multiple doses of steroids had a marked positive effect on laryngeal oedema occurrence.
- No side effects related to steroids were found in the studies.
Takeaway
Giving steroids before taking out a breathing tube can help prevent swelling in the throat and the need to put the tube back in.
Methodology
Meta-analysis of randomized placebo-controlled trials comparing parenteral steroids with placebo for preventing complications after extubation.
Potential Biases
Potential publication bias indicated by funnel plot asymmetry.
Limitations
Few studies reported intention to treat analyses, and some used supportive treatments that might have reduced the apparent benefit of steroids.
Participant Demographics
All participants were adults who were tracheally intubated for at least 24 hours.
Statistical Information
P-Value
0.002
Confidence Interval
0.17 to 0.85
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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