Document Detail


Postextubation laryngeal edema in adults. Risk factor evaluation and prevention by hydrocortisone.
MedLine Citation:
PMID:  8905428     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the risk factors for postextubation laryngeal stridor and its prevention by hydrocortisone in adult patients. DESIGN: Prospective, randomized, double-blind, placebo controlled study. SETTING: Medical and surgical ICU of a tertiary teaching hospital. PATIENTS: 77 consecutive patients of both sexes, who had undergone tracheal intubation for more than 24 h and fulfilled the weaning criteria, were eligible for the study. Patients were excluded if they were less than 15 years of age, had a disease or the surgery of the throat, or had been extubated during the current hospitalization. INTERVENTION: The control group received placebo (normal saline 3 cc) and the experimental group received hydrocortisone 100 mg by intravenous infusion 60 min before extubation. MAIN OUTCOME MEASURES: Patients were observed 24 h after extubation for symptoms or signs of laryngeal edema or stridor: prolonged inspiration with accessory usage of respiratory muscles or crowing sound with inspiration or reintubation. RESULTS: The overall incidence of postextubation stridor was 22% (17/77). Only one patient (1%), who belonged to the control group, needed reintubation. 39% of female patients and 17% of male patients developed stridor. The relative risk of females developing this complication was 2.29. 7/39 of the hydrocortisone group and 10/38 of patients in the control group developed postextubation stridor. CONCLUSIONS: Hydrocortisone did not significantly reduce the incidence of postextubation laryngeal edema or stridor. From the risk factors evaluated, we were unable to demonstrate a statistical correlation between postextubation stidor and the duration of the intubation, the patient's age, the internal diameter of the endotracheal tube, or the route of intubation. However, female patients were more likely to develop this complication.
Authors:
L I Ho; H J Harn; T C Lien; P Y Hu; J H Wang
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Intensive care medicine     Volume:  22     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  1996 Sep 
Date Detail:
Created Date:  1997-02-18     Completed Date:  1997-02-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  933-6     Citation Subset:  IM    
Affiliation:
Department of Respiratory Therapy, Veterans General Hospital-Taipei, Taiwan, R.O.C.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Inflammatory Agents / therapeutic use*
Double-Blind Method
Female
Humans
Hydrocortisone / therapeutic use*
Incidence
Intubation, Intratracheal / adverse effects*
Laryngeal Edema / drug therapy*,  etiology*
Male
Middle Aged
Premedication*
Prospective Studies
Respiratory Sounds / etiology
Risk Factors
Time Factors
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 50-23-7/Hydrocortisone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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