John, a 4 year old boy, has been mechanically ventilated for three days during recovery from a blunt chest trauma. According to his level of ventilator support, he is considered to be ready to be extubated. The previous patient had to be reintubated as a result of postextubation laryngeal oedema. You wonder whether corticosteroids may reduce this risk of extubation failure.

Structured clinical question

In mechanically ventilated children [patient] does corticosteroid administration [intervention] reduce the chance of reintubation due to laryngeal oedema [outcome]?

Search strategy and outcome

Secondary sources

Cochrane Database of Systematic Reviews; 1 limited to newborn infants.¹

PubMed clinical queries

“Respiration, Artificial”[MESH] AND (Hydroxycorticosteroids)[MESH] AND systematic; 1 reference not related to the question.

(“Intubation, Intratracheal”[MeSH]) AND systematic[sb] AND (Hydroxycorticosteroids)[MESH]; no references.

PubMed

(Anti-Inflammatory Agents OR Anti-Inflammatory Agents/therapeutic use OR Anti-Inflammatory Agents/therapy OR hydroxycorticosteroids) AND systematic[sb]) AND (“Intubation, Intratracheal”[MeSH] OR “Respiration, Artificial”[MeSH]); 25 references, 2 relevant studies^1,2) (table 2).