2019, Number 6
<< Back Next >>
Med Crit 2019; 33 (6)
Steroids post-extubation: Who? How? When?
Rodríguez GJH, Lomelí TJM, Monares ZE, Poblano MM, Hernández RHF
Language: Spanish
References: 13
Page: 315-320
PDF size: 167.26 Kb.
ABSTRACT
Post-extubation failure is a high risk complication for patients in intensive care unit. Laryngeal edema and laryngeal stridor have been studied as causes of post-extubation failure. Part of the strategies for the prevention of post-extubation failure and management of stridor or laryngeal edema is the use of steroids. The discrepancy between the time, the dos, the patient and the type of steroid forces to create a strategy that standardizes its use. This review focuses on identify patients who benefit from the use of steroids, type of steroid that should be uses, timing and correct dose.
REFERENCES
Jaber S, Jung B, Chanques G, Bonnet F, Marret E. Effects of steroids on reintubation and post-extubation stridor in adults: meta-analysis of randomised controlled trials. Crit Care. 2009;13(2):R49.
Francois B, Bellissant E, Gissot V, Desachy A, Normand S, Boulain T, et al. 12-h pretreatment with methylprednisolone versus placebo for prevention of post-extubation laryngeal edema: a randomized double-blind trial. Lancet. 2007;369:1083-1089.
Darmon JY, Rauss A, Dreyfuss D, Bleichner G, Elkharrat D, Schlemmer B, et al. Evaluation of risk factors for laryngeal edema after tracheal extubation in adults and its prevention by dexamethasone. A placebo-controlled, double-blind, multicenter study. Anesthesiology. 1992;369:245-251.
Kuriyama A, Umakoshi, Sun R. Prophylactic corticosteroids for prevention of postextubation stridor and reintubation in adults: a systematic review and meta-analysis. Chest. 2017;151:1002-1010.
Lee CH, Peng MJ, Wu CL. Dexamethasone to prevent postextubation airway obstruction in adults: a prospective, randomized, double-blind, placebo-controlled study. Crit Care. 2007;11:R72.
Argalious M. The cuff leak test: does it “leak” any information? Repir Care. 2012;57:2136-2137.
Miller R, Cole R. Association between reduced cuff leak volume and postextubation stridor. Chest. 1996;110:1035-1040.
Jaber S, Chanques G, Matecki S, Ramonatxo M, Vergne C, Souche B, et al. Postextubation stridor in intensive care unit patients. Risk factors evaluation and importance of the cuff-leak test. Intensive Care Med. 2003;29:69-74.
DeBast Y, DeBacker D, Moraine J, Lemaire M, Vandenborght C, Vincent JL. The cuff leak test to predict failure of tracheal extubation for laryngeal edema. Intensive Care Med. 2002;28:1267-1272.
Sandhu R, Pasquale M, Miller K, Wasser T. Measurement of endotracheal tube cuff leak to predict postextubation stridor and need for reintubation. J Am Coll Surg. 2000;190:682-687.
Khemani R, Randolph a, Markovitz B. Corticosteroids for the prevention and treatment of post-extubation stridor in neonates, children and adults. Cochrane Database Syst Rev. 2009;3:CD001000.
Girard T, Alhazzani W, Kress J, Ouellette D, Schmidt G, Truwit J, et al. An official American Thoracic Society/American College of Chest Phyisicians Clinical Practice Guideline: liberation from mechanical ventilation in critically ill adults. Rehabilitation protocols, ventilator liberation protocols, and cuff leak test. Am J Respir Crit Care Med. 2017;195:120-133.
Hyzy R. Extubation management in the adult intensive care unit. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. [Accessed on July 22, 2019] Available in: https://uptodate.com