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首页> 外文期刊>International Journal of Gerontology >Comparison of High- and Low-dose Dexamethasone for Preventing Postextubation Airway Obstruction in Adults: A Prospective, Randomized, Double blind, Placebo-controlled Study
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Comparison of High- and Low-dose Dexamethasone for Preventing Postextubation Airway Obstruction in Adults: A Prospective, Randomized, Double blind, Placebo-controlled Study

机译：高剂量和低剂量地塞米松预防成人拔管后气道阻塞的比较：一项前瞻性，随机，双盲，安慰剂对照研究

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Background: The study investigated the effectiveness of dexamethasone injections for reducing the occurrence of postextubation airway obstruction (PEAO). Methods: One hundred and thirty-eight patients who were intubated for >= 48 hours with a cuff-leak volume (CLV) < 110 mL were treated with low-dose dexamethasone (5 mg; n = 41), high-dose dexamethasone (10 mg; n = 42), or placebo (normal saline; n = 43) injection every 6 hours for a total of four doses on the day preceding extubation. CLV was measured before the first injection, 1 hour after each injection, and 24 hours after the fourth injection. Extubation was performed 24 hours after the last injection. PEAO was recorded within 48 hours postextubation. Results: Administration of dexamethasone resulted in a significant increase in absolute CLV and change of CLV relative to baseline tidal volume occurred (p < 0.05). However, there was no significant difference between the low- and high-dose dexamethasone groups. The incidence of PEAO was 7.1% in the high-dose group, 9.8% in the low-dose group, and 30.2% in the placebo group. The incidence of PEAO differed significantly between the dexamethasone groups and the placebo group (p = 0.001). There was no significant difference in the reintubation rates among the high-dose group (2.1%, 1/42), the low-dose group (2.4%, 1/41), and the placebo group (4.7%, 2/43; p = 0.79). Conclusion: Prophylactic administration of multiple low-dose dexamethasone is sufficient for reducing the incidence of PEAO in high-risk patients.
机译：背景：该研究调查了地塞米松注射液减少拔管后气道阻塞（PEAO）发生的有效性。方法：138例患者，其袖带漏量（CLV）<110 mL插管> = 48小时，接受低剂量地塞米松（5 mg; n = 41），大剂量地塞米松（拔管前一天每6小时注射10 mg; n = 42）或安慰剂（生理盐水; n = 43），共4剂。在第一次注射前，每次注射后1小时和第四次注射后24小时测量CLV。在最后一次注射后24小时进行拔管。拔管后48小时内记录PEAO。结果：地塞米松的使用导致绝对CLV显着增加，并且CLV相对于基线潮气量发生了变化（p <0.05）。但是，低剂量和高剂量地塞米松组之间没有显着差异。高剂量组PEAO的发生率为7.1％，低剂量组为9.8％，安慰剂组为30.2％。地塞米松组和安慰剂组之间PEAO的发生率显着不同（p = 0.001）。高剂量组（2.1％，1/42），低剂量组（2.4％，1/41）和安慰剂组（4.7％，2/43）之间的再插管率没有显着差异。 p = 0.79）。结论：多次低剂量地塞米松的预防性给药足以降低高危患者PEAO的发生率。

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