SynthesisIntensive care medicine2009
Corticosteroids to prevent extubation failure: a systematic review and meta-analysis.
Synthesis in Intensive care medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 55 citations in OpenAlex.
- Comparative efficacies of various corticosteroids for preventing postextubation stridor and reintubation: a systematic review and network meta-analysis.Frontiers in medicine · 2023Pooled it
- Multicenter randomized clinical trial comparing dexamethasone versus placebo in preventing upper airway obstruction after extubation in critically ill children.Scientific reports · 2022Trial
- Patients' prediction of extubation success.Intensive care medicine · 2010Trial
- Association of Prophylactic Corticosteroids with Post-Extubation Outcomes in Pediatric Cardiac Critical Care: A Retrospective Propensity-Weighted Cohort Study.Journal of clinical medicine · 2026Article
- Predictors and outcomes of extubation failures in a pediatric intensive care unit: A retrospective study.Journal of Taibah University Medical Sciences · 2024Article
- A Review of Prolonged Mechanical Ventilation in Pediatric Cardiac Surgery Patients: Risk Factors and Implications.Journal of multidisciplinary healthcare · 2024Review
- Developing an Extubation strategy for the difficult pediatric airway-Who, when, why, where, and how?Paediatric anaesthesia · 2022Review
- Use of Dexamethasone to Prevent Extubation Failure in Pediatric Intensive Care Unit: A Randomized Controlled Clinical Trial.Journal of pediatric intensive care · 2022Article
- A descriptive survey of tracheal extubation practices among Indian anaesthesiologists.Indian journal of anaesthesia · 2021Article
- Article
- Effectiveness of corticosteroids for post-extubation stridor and extubation failure in pediatric patients: a systematic review and meta-analysis.Annals of intensive care · 2020Review
- Protective role of ACE2 and its downregulation in SARS-CoV-2 infection leading to Macrophage Activation Syndrome: Therapeutic implications.Life sciences · 2020Review
- Post-extubation stridor in Respiratory Syncytial Virus bronchiolitis: Is there a role for prophylactic dexamethasone?PloS one · 2017Observational
- All India Difficult Airway Association 2016 guidelines for the management of anticipated difficult extubation.Indian journal of anaesthesia · 2016Article
- Prediction of extubation failure in newborns, infants and children: brief report of a prospective (blinded) cohort study at a tertiary care paediatric centre in India.SpringerPlus · 2015Article
- Managing the apparent and hidden difficulties of weaning from mechanical ventilation.Intensive care medicine · 2013Review
- Scientific rationale for the use of alpha-adrenergic agonists and glucocorticoids in the therapy of pediatric stridor.International journal of otolaryngology · 2011Article
- Steroids for post extubation stridor: pediatric evidence is still inconclusive.Intensive care medicine · 2010Article
- Year in review in Intensive Care Medicine 2009. Part III: mechanical ventilation, acute lung injury and respiratory distress syndrome, pediatrics, ethics, and miscellanea.Intensive care medicine · 2010Review
- Assistance of inhalation injury victims caused by fire in confined spaces: what we learned from the tragedy at Santa Maria.Revista Brasileira de terapia intensivaArticle
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo determine whether corticosteroids reduce the rate of extubation failure in intensive care patients of all age groups.
methodsMedline, EMBASE, the Cochrane Central Register of Controlled Trials, bibliographies of relevant articles, selected conference abstracts and unpublished trial databases were searched. Randomised clinical trials (RCTs) evaluating corticosteroids for the purpose of preventing extubation failure in mechanically ventilated, critically ill patients of all ages were included. Two authors independently assessed the validity of included studies and extracted data regarding characteristics of the studies and the rates of reintubation and manifestations of laryngeal oedema.
resultsFourteen RCTs including 2,600 participants were included. The mean duration of ventilation prior to attempted extubation ranged from 3 to 21 days. There was a reduction in reintubation with the use of corticosteroids, with a pooled odds ratio (OR) of 0.56 (95% CI; 0.41-0.77, P < 0.0005). The effect of corticosteroids tended to be more pronounced in studies when used at least 12 h prior to attempted extubation (OR 0.41, 95% CI; 0.26-0.64). The results were consistent across neonatal, paediatric and adult populations. There was also a reduction in laryngeal oedema in participants receiving corticosteroids, with a pooled OR of 0.36 (95% CI 0.27-0.49, P < 0.0005).
conclusionsCorticosteroids reduce laryngeal oedema and importantly reduce the incidence of extubation failure in critically ill patients of all ages.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.