L-Epinephrine and dexamethasone in postextubation airway obstruction: A prospective, randomized, double-blind placebo-controlled study

L-Epinephrine and dexamethasone in postextubation airway obstruction: A prospective, randomized, double-blind placebo-controlled study

Author Cesar, Regina Grigolli Google Scholar
Carvalho, Werther Brunow de Autor UNIFESP Google Scholar
Institution Sch Med
Universidade Federal de São Paulo (UNIFESP)
Abstract Purpose: This prospective randomized double-blind placebo-controlled study paired trial groups to investigate the effect of intravenous dexamethasone and nebulized L-epinephrine on the clinical development of postextubation laryngeal edema.Material and methods: Sixty-four patients aged 1 day to 12 years who needed intubation from August/1997 to February/1999 in the Pediatric Intensive Care Unit (PICU) of Santa Casa de São Paulo School of Medicine were paired according to age, height and weight, anthropometric z-scores, duration of tracheal intubation and number of intubation attempts. Patients received intravenous dexamethasone (0.2 mg/kg every 6 h), with or without nebulized L-epinephrine (0.5 mg/kg every 4 h) in the study groups; in the control groups, they received nebulized or intravenous isotonic saline solution, or both. Dependent variables: frequency and severity of the laryngeal edema (according to Westley Clinical Scoring System), as well as the time interval (min) between extubation and the first postextubation laryngeal edema scores. Postextubation respiratory rate and transcutaneous oxygen saturation were employed as indicators of the clinical conditions for extubation.Results: Laryngeal edema frequencies did not change according to treatments, chi(2) (3, N = 64) = 0.58, p > 0.05, and the highest scores were not reached in the 24 h after extubation, chi(2)(ranks) (3, N = 16) = 1.03, p > 0.05.Conclusions: Dexamethasone and L-epinephrine did not reduce the clinical progression of airway obstruction due to laryngeal edema in the early postextubation period. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
Keywords Laryngeal edema
Epinephrine
Dexamethasone
Language English
Date 2009-12-01
Published in International Journal of Pediatric Otorhinolaryngology. Clare: Elsevier B.V., v. 73, n. 12, p. 1639-1643, 2009.
ISSN 0165-5876 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 1639-1643
Origin http://dx.doi.org/10.1016/j.ijporl.2009.08.004
Access rights Closed access
Type Review
Web of Science ID WOS:000272855900006
URI http://repositorio.unifesp.br/handle/11600/31991

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