地塞米松用于预防儿科重症监护病房拔管失败：一项随机对照临床试验。
Use of Dexamethasone to Prevent Extubation Failure in Pediatric Intensive Care Unit: A Randomized Controlled Clinical Trial.
作者信息
Carvalho Haroldo Teófilo de, Fioretto José Roberto, Bonatto Rossano Cesar, Ribeiro Cristiane Franco, Martin Joelma Gonçalves, Carpi Mário Ferreira
机构信息
Department of Pediatrics, Botucatu School of Medicine, São Paulo State University, Botucatu, São Paulo, Brazil.
出版信息
J Pediatr Intensive Care. 2020 Nov 3;11(1):41-47. doi: 10.1055/s-0040-1719044. eCollection 2022 Mar.
Abstract
Extubation failure is a common event in intensive care units. Corticosteroids are effective in preventing failure in adults, but no consensus has been reached on this matter in pediatrics. We assessed the efficacy of intravenous dexamethasone in mechanically ventilated children and adolescents for more than 48 hours, with at least one risk factor for failure. Extubations were scheduled 24 hours in advance when possible, and patients were randomly assigned into two groups: one group received a loading dose followed by up to four doses of dexamethasone, and the other group received no corticosteroids. Need for reintubation and length of stay in the pediatric intensive care unit were similar in both groups, and frequency of reintubation was 12.9%.
摘要
拔管失败在重症监护病房是常见事件。皮质类固醇对预防成人拔管失败有效，但在儿科对此问题尚未达成共识。我们评估了静脉注射地塞米松对机械通气超过48小时且至少有一项拔管失败风险因素的儿童和青少年的疗效。尽可能提前24小时安排拔管，患者被随机分为两组：一组接受负荷剂量，随后最多接受四剂地塞米松，另一组不接受皮质类固醇。两组在儿科重症监护病房的再插管需求和住院时间相似，再插管频率为12.9%。
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