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Volume 3 Supplement 2

19th International Symposium on Intensive Care and Emergency Medicine

Evaluating the effect of steroids on the incidence of reintubation rates in children with laryngotracheobronchitis

Introduction

Postextubation stridor is a serious problem in children with an incidence of up to 33% in electively intubated children. Our aim was to determine whether steroids decreased reintubation rates and to identify other risk factors for reintubation.

Methods

Retrospective analysis (1994–1996) of the 82 children (72 received steroids). Steroids were categorized according to the type used and the time of administration. Recognized risk factors for postextubation stridor including age (<1 and >1 year) and duration of intubation (< 120 and >120 h) were analyzed.

Results

There was no significant difference in either the preintubation grade or stridor (P = 0.67) in both outcome groups (reintubated 22/23 grade 3 and not-reintubated 50/59 grade 3) or in the postextubation grade of stridor between both groups (P = 0.1). Neither type of steroid (P = 0.32), nor time administered (P = 0.79), nor age (P = 0.22) nor duration of intubation (P = 0.35) was found to significantly influence reintubation rates.

Conclusion

The prophylactic use of corticosteroids in routine elective extubations for laryngotracheobronchitis cannot be recommended, based on current findings. Overall, 28% of all patients needed to be reintubated. However, reintubation seems to be correlated best with atelectasis rather than the degree of postextubation stridor.

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Rajah, J., Riera-Fanego, J., Keeton, J. et al. Evaluating the effect of steroids on the incidence of reintubation rates in children with laryngotracheobronchitis. Crit Care 3, P013 (2000). https://doi.org/10.1186/cc388

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Keywords

  • Public Health
  • Steroid
  • Corticosteroid
  • Emergency Medicine
  • Retrospective Analysis