Corticosteroids for prevention of postextubation laryngeal edema in adults

The Annals of Pharmacotherapy
Russel J RobertsJohn W Devlin

Abstract

To evaluate the efficacy and safety of prophylactic corticosteroid therapy in preventing postextubation laryngeal edema (PELE) and the need for reintubation in adults. Literature was accessed through MEDLINE (1966-January 2008) and the Cochrane Library using the terms laryngeal edema, airway obstruction, postextubation stridor, intubation, glucocorticoids, and corticosteroids. Bibliographies of cited references were reviewed and a manual search of abstracts from recent pulmonary and critical care meetings was completed. All English-language, placebo-controlled, randomized studies evaluating the use of prophylactic corticosteroids for the prevention of postextubation laryngeal edema or postextubation stridor (PES) in adults were reviewed. Although laryngoscopy is the gold standard method for diagnosing PELE, PES is more commonly used for diagnosis in clinical practice. While 3 older studies failed to demonstrate benefit with the prophylactic administration of corticosteroid therapy in terms of reducing PELE, PES, or the need for reintubation, each of these studies evaluated only a single dose of steroid therapy that was initiated only 30-60 minutes prior to a planned extubation in a population of patients at low-risk for PELE. I...Continue Reading

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Citations

Dec 19, 2009·Critical Care : the Official Journal of the Critical Care Forum·Bastiaan H J WittekampDennis C J J Bergmans
Jan 1, 2010·The Pan African Medical Journal·Okafor Ugochukwu, Azike Jerome
Nov 17, 2012·The Surgical Clinics of North America·Jeremy S Juern
Sep 24, 2015·Critical Care : the Official Journal of the Critical Care Forum·Wouter A PluijmsDennis Cjj Bergmans
May 6, 2016·Neurology India·Amlan SwainPravin Salunke
Feb 12, 2017·Korean journal of anesthesiology·Tae-Yop Kim
Aug 29, 2013·The Neurohospitalist·M J Souter, Edward M Manno
Jul 10, 2009·The Cochrane Database of Systematic Reviews·Robinder G KhemaniBarry Markovitz

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