Dr. Samir Jaber and colleagues of the University of Montpellier in France conducted a study regarding the effects of steroid therapy in reducing the incidence of reintubation and post-extubation stridor.

The team conducted clinical trials on selected and random patients in terms of their risk of intubation and stridor. On the trials involving selected high-risk patients, the researchers report lesser incidence of reintubation and post-extubation stridor. However, in randomly selected patients, results were less well defined.

In terms of the schedule of steroid administration, two trials were performed. One trial administered steroids in patients at least four hours before the planned intubation while the second trial administered steroids at a later time. Results of these trials showed that steroid treatment was only effective when taken at least four hours before and does not effectively lower stridor and reintubation when administered at a later time.

The meta-analysis made the researchers conclude that all of these criteria must be followed in order to maximize the effectiveness of prophylactic steroid treatment; it should be administered at least four hours before through intravenous injection and it is only effective in patients with high risk of developing stridor and reintubation.

From Medscape Today:

NEW YORK (Reuters Health) Apr 27 – Steroid use at least 4 hours prior to extubation reduces the risk of reintubation and stridor in selected high-risk patients, according to a report in the April 3rd Critical Care.

Prophylactic steroid therapy to prevent post-extubation stridor and reintubation remains controversial in both selected and nonselected patients, the authors explain