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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 studies1,2) (table 2).
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Footnotes
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Bob Phillips