Abstract

Introduction:Extubation failure increases morbidity and mortality in intensive care. Laryngeal edema which developed post extubation is one of the major risk factor for extubation failure. Post extubation laryngeal edema occurs in up to 37% of the extubations. Steroids are commonly used pre extubation to prevent development of laryngeal edema. Aim of this study was to find whether steroids can prevent post extubation laryngeal edema and types of patients who frequently fails extubation. Patients and methods:It was a prospective observational study conducted in a tertiary hospital Surgical Intensive Care Unit (SICU). All patients included in study received one of the steroid regimes or no steroid. Patients with tracheostomy, pediatric age group, pregnant patients, and patients who were already on steroid therapy were excluded from the study. Data entered in SPSS program, chi-square test was used to compare the variables and a p value of < 0.05 was considered as significant. Results:A total of 489 patients were enrolled in the study, 63 were excluded. Methylprednisolone was the most frequently (49.3%) used steroid. Majority of patients (80.1%) were male. Patients who did not received steroid before extubation had a higher percentage of post extubation stridor and reintubation (p < 0.05). Reintubation was more common in male, young patients, severe brain injury patients and patients with higher severity of the disease. Conclusion:Steroids can prevent post extubation laryngeal edema and subsequently prevent extubation failure. Extubation failure was more common occurs in male, young, severely ill and severe brain injury patients.

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