Does prophylactic use of dexamethasone have a role in reducing post extubation stridor and reintubation in children?

Abstract

To determine the role of Dexamethasone (DEX) in postextubation stridor (PS) frequency and reintubation rate in critically ill infants and children. This study was conducted in a pediatric intensive care unit of a university hospital. This was a retrospective case-control study. All children aged from 4 weeks to <5 year, were intubated for at least 48 hours [n=51] during 6 months. Data of the patients treated with DEX (0.5 ml/kg every 6 hours for 3 doses, beginning 6-12 hours prior to extubation) (n=30) were compared with control patients (who had not received medication) (n=21). The DEX and control groups were similar in age i.e., mean ages of DEX group were 16.85±14 months, and that of control group were 19.02 ± 19 months, mean duration of intubation and mechanical ventilation in DEX group was 5.17 ± 4.58 days, and that in control group was 3.98 ± 3.60 days. There was no significant difference between DEX and control group in the incidence of postextubation stridor [17% (5/30) vs. 10% (2/21); p = 0.5] and the reintubation rate [7% (2/30) vs. 10% (2/21); p = 0.7]. Our data revealed that the prophylactic use of dexamethasone in planned extubation of high risk children were not effective.