Table 1 Characteristics of the seven adult studies included in the meta-analysis
Author, year | Jadad scale | Overall sample size analysed (n) | ICU population and inclusion criteria | Duration of ventilation (days) (steroid vs placebo) | Steroid dose and regimen administration | Overall equivalent dose of hydrocortisone (mg) |
|---|---|---|---|---|---|---|
Cheng and colleagues 2007[8] | 3 | 71 | Medical and surgical MV for more than 24 hours High risk of stridor (CLV < 24%) | NR | Methylprednisolone IV 40 mg, 4 hours before extubation | 200 |
Cheng and colleagues 2006[9] | 5 | 128 | Medical and surgical MV for more than 24 hours High risk of stridor (CLV < 24%) | 7.3 ± 3.9 (1 inj) 6.3 ± 3.8 (4 inj) vs 7.1 ± 4.1 (placebo) | Methylprednisolone IV 40 mg/6 hours × 4 vs Methylprednisolone IV 40 mg – 1 injection vs placebo Started 24 hours before extubation | 800 or 200 |
Darmon and colleagues 1992[10] | 5 | 694 | Medical and surgical MV for more than 36 hours Not selected at high-risk | 9.6 ± 9.7 vs 10.3 ± 10.9 | Dexamethasone IV 8 mg one hour before extubation | 213 |
Francois and colleagues 2007[11] | 5 | 698 | Medical, surgical and trauma MV for more than 36 hours Not selected at high-risk | Duration of MV < 7 days: 51 vs 49% Duration of MV > 7 days: 49 vs 51% | Methylprednisolone IV 20 mg/4 hours starting 12 hours before planned extubation (last dose just before extubation) | 400 |
Ho and colleagues 1996[12] | 5 | 77 | Medical and surgical Not selected at high-risk | 6.1 ± 3.8 vs 4.6 ± 4.7 | Hydrocortisone IV 100 mg one hour before extubation | 100 |
Lee and colleagues 2007[13] | 5 | 86 | Medical MV for more than 48 hours High risk of stridor (CLV < 110 ml) | 7.0 ± 2.0 vs 6.6 ± 2.0 | Dexamethasone IV 5 mg/6 hours × 4 – started 24 hours before extubation, last dose just before extubation | 533 |
Shih and colleagues 2007[14] | 3 | 98 | Medical and surgical MV for more than 24 hours | Between 10 and 15 | Hydrocortisone IV 4 injections/6 hours Started 24 hours before | NR |