Postextubation laryngeal edema and stridor resulting in respiratory failure in critically ill adult patients: updated review

Pluijms, Wouter A.; van Mook, Walther NKA; Wittekamp, Bastiaan HJ; Bergmans, Dennis CJJ

doi:10.1186/s13054-015-1018-2

Critical Care

Table 5 The effect of corticosteroids on postextubation laryngeal edema, stridor, respiratory distress, and reintubation

From: Postextubation laryngeal edema and stridor resulting in respiratory failure in critically ill adult patients: updated review

Author	Year	Intervention	Time before extubation	Intervention group			Control group
				Outcome parameter	Number	Percentage	Outcome parameter	Number	Percentage	P value
Darmon et al. [12]	1992	Dexamethasone 8 mg i.v.	1 hour	Laryngeal edema	11/327	3.4 %	Laryngeal edema	17/337	5.0 %	ns
Ho et al. [17]	1996	Hydrocortisone 100 mg i.v.	1 hour	Laryngeal edema	7/39	17.9 %	Laryngeal edema	10/38	26.3 %	ns
Cheng et al. [16]	2006	Methylprednisolone 40 mg i.v.	24 hours	Stridor	5/43	11.6 %	Stridor	13/43	30.2 %	0.15
Cheng et al. [16]	2006	Methylprednisolone 40 mg i.v.	24 hours	Reintubation	3/43	6.9 %	Reintubation	11/43	25.6 %	NA
		Methylprednisolone 4 × 40 mg i.v.	24 hours	Stridor	3/42	7.1 %	Stridor	13/43	30.2 %	0.005
		Methylprednisolone 4 × 40 mg i.v.	24 hours	Reintubation	7/42	16.7 %	Reintubation	11/43	25.6 %	NA
François et al. [11]	2007	Methylprednisolone 3 × 20 mg i.v.	12 hours	Laryngeal edema	11/355	3.1 %	Laryngeal edema	76/343	22. %	<0.01
François et al. [11]	2007	Methylprednisolone 3 × 20 mg i.v.	12 hours	Reintubation	13/355	3.7 %	Reintubation	36/343	10.5 %	0.02
Lee et al. [30]^a	2007	Dexamethasone 4 × 5 mg i.v.	48 hours	Stridor	4/40	10 %	Stridor	11/40	27.5 %	0.037
Lee et al. [30]^a	2007	Dexamethasone 4 × 5 mg i.v.	48 hours	Reintubation	1/40	2.5 %	Reintubation	2/40	5.0 %	0.56
Cheng et al. [26]^b	2011	Methylprednisolone 40 mg i.v.	4 hours	Stridor	6/38	15.8 %	Stridor	13/33	39.4 %	0.025
Cheng et al. [26]^b	2011	Methylprednisolone 40 mg i.v.	4 hours	Reintubation	3/38	7.9 %	Reintubation	10/33	30.3 %	NA
Abbasi et al. [29]	2014	Budesonide 4 × 1 mg nebulized	48 hours	Respiratory distress	3/35	8.6 %	Respiratory distress	11/35	31.4 %	0.017
				Stridor	3/35	8.6 %	Stridor	7/35	20 %	0.17
				Reintubation	3/35	8.6 %	Reintubation	11/35	31.4 %	0.017

i.v. intravenous, ns not significant, NA not applicable
^aOnly patients with cuff leak volume (CLV) <110 ml were included. In patients with CLV ≥110 ml, stridor was found in 4.9 % of patients, and 1.4 % of patients were reintubated
^bOnly patients with cuff leak percentage (CLP) <24 % were included. In patients with CLP ≥24 %, stridor was found in 3.8 % of patients, and intubation was performed in 5 % of patients

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