摘要
Abstract
Objective To evaluate the effects of glucocorticoids in prevention of post- extubative laryngeal stridor and reintubation in critical il adults. Methods Literatures in Chinese periodical database, Pubmed, Embase, Web of Science database from January1980 to June 2013 were searched. The randomized- double blind- placebo control ed clinical trials of post- extubative laryngeal stridor and reintubation after intravenous injection of dexamethasone, hydrocortisone, methylpred-nisolone in critical il adults were reviewed. The meta analysis was performed with the software recommended by Cochrane Col-laboration. Results A total of 884 glucocorticoid- pretreated cases and 833 saline placebo controls from six clinical trials were included. The high risk patients of laryngeal stridor were screened by cuff leak volume in 3 trials;while high risk patients were not screened in another 3 trials. Intravenous glucocorticoids reduced the incidence of post- extubative laryngeal stridor (RR=0.37, 95%CI 0.21~0.64) and incidence of reintubation(RR=0.40, 95%CI 0.25~0.63). In subgroups without high risk screening glucocor-ticoids administration did no affect the incidence of post- extubative laryngeal stridor (RR=0.39, 95%CI 0.13~1.21). Conclusion Intravenous injection of glucocorticoids can reduce the incidence of post- extubative laryngeal stridor and reintubation in critical il adults with high risk.关键词
糖皮质激素/气管拔管/喉喘鸣/再插管Key words
Glucocorticoid/Tracheal extubation/Laryngeal stridor/Reintubation
