Effectiveness of corticosteroids for post-extubation stridor and extubation failure in pediatric patients: a systematic review and meta-analysis

Annals of Intensive Care
Satoshi KimuraStefania Papatheodorou

Abstract

While the results of previous meta-analyses have shown beneficial effects of corticosteroid therapy on post-extubation stridor and extubation failure in adults, these results might not be generalizable to children because of the differences in anatomy and structure. We aimed to determine the benefits of corticosteroids on those outcomes in pediatric populations. We searched PubMed, EMBASE, and reference lists of articles from inception until February 2019. Randomized controlled trials and observational studies on the efficacy of systemic corticosteroid administration given prior to elective extubation in mechanically ventilated pediatrics were eligible. Outcomes included post-extubation stridor indicating laryngeal edema and extubation failures. A total of ten randomized controlled trials with 591 pediatric patients were included: seven of the ten studies for post-extubation stridor/suspected upper airway obstruction and nine of the ten studies for extubation failure. The estimate of pooled odds ratios (ORs) for post-extubation stridor/suspected upper airway obstruction was 0.40 (95% CI: 0.21-0.79). When analysis was restricted to trials that had explicit data for infants and explicit data for pediatric patients under 5 years o...Continue Reading

References

Feb 1, 1991·The Journal of Pediatrics·D W TellezT W Deakers
Mar 1, 1991·Critical Care Medicine·K J KemperM J Bishop
Mar 1, 1985·Progress in Cardiovascular Diseases·S YusufP Sleight
Sep 1, 1986·Controlled Clinical Trials·R DerSimonian, N Laird
Sep 1, 1965·The Annals of Otology, Rhinology, and Laryngology·W L Way, F A Sooy
Jul 1, 1995·American Journal of Respiratory and Critical Care Medicine·A TorresR Rodriguez-Roisin
Oct 6, 1997·BMJ : British Medical Journal·M EggerC Minder
Sep 6, 2003·BMJ : British Medical Journal·Julian P T HigginsDouglas G Altman
Oct 21, 2005·The New England Journal of Medicine·Turk Rhen, John A Cidlowski
Apr 17, 2008·The Annals of Pharmacotherapy·Russel J RobertsJohn W Devlin
Apr 9, 2009·Intensive Care Medicine·John McCaffreyAnthony P Delaney
Jul 22, 2009·PLoS Medicine·David MoherUNKNOWN PRISMA Group
Sep 19, 2009·International Journal of Pediatric Otorhinolaryngology·Regina Grigolli Cesar, Werther Brunow de Carvalho
Mar 20, 2010·Intensive Care Medicine·Robinder G KhemaniBarry Markovitz
Oct 20, 2011·BMJ : British Medical Journal·Julian P T HigginsUNKNOWN Cochrane Statistical Methods Group
Jul 3, 2013·Journal of Intensive Care Medicine·James L LahamAmanda Rush
Jan 31, 2015·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Bonny B DragoKanwaljeet J S Anand

❮ Previous
Next ❯

Software Mentioned

Covidence
R
Cochrane

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.