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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
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
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
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
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
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
  1. i.v. intravenous, ns not significant, NA not applicable
  2. 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
  3. 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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