Post-extubation Airway Obstruction in Children: Are Steroids the Key to
Prevention?
Abstract
Reintubation in the pediatric intensive care unit (PICU) increases
morbidity, mortality, and the overall cost of care. Post-extubation
airway obstruction (PEAO) is a potentially predictable cause of
extubation failure and may be prevented by the use of corticosteroids.
Defining which patients are most at risk for the development of POAE as
well as the optimal dose and timing of corticosteroids for prevention is
critical. We review the current literature regarding the use of
corticosteroids surrounding extubation in the PICU and discuss the
implications that a clear algorithm for identification and treatment of
these patients would have in the care of critically ill children.