Published 20 October 2008, doi:10.1136/bmj.a1565
Cite this as: BMJ 2008;337:a1565

Editorials

Preventing postextubation airway complications in adults

Corticosteroids should be given only to patients at high risk of reintubation

The first 150 words of the full text of this article appear below.

To receive artificial ventilation for acute respiratory failure adult patients usually have an endotracheal tube placed through the mouth and larynx into the upper trachea. Although initially life saving, the endotracheal tube causes mechanical irritation of the larynx and trachea, which in turn may cause inflammation and oedema. Infected oral secretions pooling in the larynx above the cuff of the endotracheal tube will exacerbate the inflammation. While present the endotracheal tube acts as a stent, but when it is removed these processes may narrow the upper airway, leading to symptoms and signs of upper airway obstruction and at worst the need for reintubation. In the linked meta-analysis (doi:10.1136/bmj.a1841), Fan and colleagues assess whether steroids are effective in preventing postextubation laryngeal oedema and reducing the need for subsequent reintubation of the trachea in critically ill adults.1

The scale of the problem is difficult to assess, because estimates of the . . . [Full text of this article]

Duncan Young, consultant in intensive care medicine, Peter Watkinson, consultant in intensive care medicine

1 Intensive Care Society Trials Group, Kadoorie Centre for Critical Care Research and Education, John Radcliffe Hospital, Oxford OX3 9DU

duncan.young@nda.ox.ac.uk


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Article

Prophylactic administration of parenteral steroids for preventing airway complications after extubation in adults: meta-analysis of randomised placebo controlled trials
Tao Fan, Gang Wang, Bing Mao, Zeyu Xiong, Yu Zhang, Xuemei Liu, Lei Wang, and Sai Yang
BMJ 2008 337: a1841. [Abstract] [Full Text] [PDF]

Access jobs at BMJ Careers
Whats new online at Student BMJ