Dexamethasone in the prevention of postextubation stridor in children

J Pediatr. 1991 Feb;118(2):289-94. doi: 10.1016/s0022-3476(05)80505-0.


To assess whether there is any advantage in the use of corticosteroid to prevent postextubation stridor in children, we conducted a prospective, randomized, double-blind trial of dexamethasone versus saline solution. The patients were evaluated and then randomly selected to receive either dexamethasone or saline solution according to a stratification based on risk factors for postextubation stridor: age, duration of intubation, upper airway trauma, circulatory compromise, and tracheitis. Dexamethasone, 0.5 mg/kg, was given every 6 hours for a total of six doses beginning 6 to 12 hours before and continuing after endotracheal extubation in a pediatric intensive care setting. There was no statistical difference in incidence of postextubation stridor in the two groups; 23 of 77 children in the placebo group and 16 of 76 in the dexamethasone group had stridor requiring therapy (p = 0.21). We conclude that the routine use of corticosteroids for the prevention of postextubation stridor during uncomplicated pediatric intensive care airway management is unwarranted.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Child
  • Child, Preschool
  • Dexamethasone / therapeutic use*
  • Double-Blind Method
  • Humans
  • Infant
  • Intensive Care Units, Pediatric
  • Intubation, Intratracheal / adverse effects
  • Laryngeal Edema / prevention & control
  • Prospective Studies
  • Respiratory Sounds* / etiology
  • Risk Factors


  • Dexamethasone