Lukkassen Ingrid M A, Hassing Marre B F, Markhorst Dick G
Department of Paediatrics, St Antonius Hospital, Nieuwegein, The Netherlands.
Acta Paediatr. 2006 Jan;95(1):74-6. doi: 10.1080/08035250500325066.
To study the effect of dexamethasone on postextubation stridor (PS) incidence and reintubation rate due to PS in a high-risk paediatric intensive care population.
All children aged between 4 wk and 6 y, who were intubated for at least 24 h and extubated between August 1999 and May 2002, were retrospectively included (n=60). Medical records of the included patients were studied; records of patients treated with dexamethasone prior to and following extubation (n=23) were compared with control patients who had not received prophylactic medication (n=37).
Nine patients in the control group developed significant postextubation stridor, necessitating nebulized epinephrine or glucocorticosteroids. In six of these children, reintubation as a result of postextubation stridor was indicated. None of the patients treated with dexamethasone developed severe postextubation stridor or required reintubation.
The risk of postextubation stridor is relatively high in the group of children aged between 4 wk and 6 y with intubation exceeding 24 h. We found dexamethasone to be effective in preventing reintubation due to postextubation stridor in this paediatric high-risk group.
研究地塞米松对高危儿科重症监护人群拔管后喘鸣（PS）发生率及因PS导致的再次插管率的影响。
回顾性纳入1999年8月至2002年5月期间所有年龄在4周龄至6岁之间、插管至少24小时且已拔管的儿童（n = 60）。研究纳入患者的病历；将拔管前后接受地塞米松治疗的患者（n = 23）的记录与未接受预防性用药的对照患者（n = 37）的记录进行比较。
对照组中有9名患者出现明显的拔管后喘鸣，需要雾化吸入肾上腺素或糖皮质激素。在这些儿童中，有6名因拔管后喘鸣而需要再次插管。接受地塞米松治疗的患者中无一例出现严重的拔管后喘鸣或需要再次插管。
在插管超过24小时的4周龄至6岁儿童组中，拔管后喘鸣的风险相对较高。我们发现地塞米松在预防该儿科高危组因拔管后喘鸣导致的再次插管方面是有效的。
