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Randomized Controlled Trial
. 2021 Jul;56(7):2292-2301.
doi: 10.1002/ppul.25388. Epub 2021 Apr 5.

Twenty-four-hour pretreatment with low dose (0.25 mg/kg/dose) versus high dose (0.5 mg/kg/dose) dexamethasone in reducing the risk of postextubation airway obstruction in children: A randomized open-label noninferiority trial

Biraj Parajuli  1 , Arun K Baranwal  2 , Praveen Kumar-M  3 , Muralidharan Jayashree  2 , Lalit Takia  2
Affiliations
Randomized Controlled Trial

Twenty-four-hour pretreatment with low dose (0.25 mg/kg/dose) versus high dose (0.5 mg/kg/dose) dexamethasone in reducing the risk of postextubation airway obstruction in children: A randomized open-label noninferiority trial

Biraj Parajuli et al. Pediatr Pulmonol. 2021 Jul.

Abstract

Objective: Multidose dexamethasone pretreatment reduces risk of postextubation airway obstruction (PEAO). However, its optimal dose is not known. We planned to compare 24 h pretreatment with low-dose dexamethasone (LDD) (0.25 mg/kg/dose) versus high-dose dexamethasone (HDD) (0.5 mg/kg/dose) in reducing risk of PEAO.

Design: Stratified (for age and intubation duration) randomized open-label noninferiority trial.

Setting: Fifteen-bed pediatric intensive care unit in a lower-middle-income country.

Patients: Children (3 months-12 years) intubated for more than or equal to 48 h and planned for first extubation (February 17-March 19). Upper airway conditions, chronic respiratory diseases, chronic NSAID therapy, steroid, or intravenous immunoglobulin in the last 7 days, presence of gastrointestinal bleeding, hypertension, and hyperglycemia were exclusions.

Interventions: LDD (n = 144) or HDD (n = 143) (q6h) for a total of six doses. Extubation was planned immediately after fifth dose. Noninferiority margin was kept at 12% from baseline.

Keywords: Children; dexamethasone; intubation; postextubation airway obstruction; postextubation stridor; steroid.

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References

REFERENCES

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