Abstract PD-051: ROLE OF STEROIDS IN PREVENTION OF POST EXTUBATION STRIDOR

Abstract

Aims & Objectives: Primary-To study the effect of prophylactic steroids on occurance of post extubation stridor (PES) in ventilated children. Secondary-To compare the severity of PES in ventilated children receiving prophylactic steroids or placebo. Methods Setting- PICU of Lok Nayak Hospital, Delhi in 2014 - 2015 Patients-Children aged 2 months to 12 years, ventilated for at least 48 hours and planned for extubation in next 6–12 hours.Children ventilated through tracheostomy, receiving steroids within 7 days before extubation, having unplanned self extubation, and previously failed extubation were excluded. Intervention-Group A received dexamethasone 0.15 mg/kg 6 hourly for 6 doses at extubation while group B received placebo (normal saline). Stridor scoring was done using Westley stridor score. Results Group A comprised of 42 children while group B had 38 children. PES occurred in total 48.7% children with 42.8% in dexamethasone group and 55.2% in placebo group (p=0.26). The median age of children with PES was 6 months and without PES was 18 months (p=0.05). Stridor score >4 was present in 28.5% of dexamethasone group vs 47.3% of placebo group (p=0.08). Median stridor scores were same in both groups (score 2 in each group). 38% patients in group A compared to 47.3% in Group B required adrenaline nebulization (p=0.40). There was no difference in the incidence of PES with the duration of ventilation (p=0.38). There were no significant adverse effects of steroids. Conclusions We didn’t find significant difference in the incidence of PES and severity of stridor in ventilated patients receiving dexamethasone or placebo.