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Postextubation laryngeal edema leading to respiratory distress is a primary reason for unplanned reintubation. Researchers in France prospectively randomized 698 adult intensive care unit (ICU) patients who had been intubated for longer than 36 hours to receive either methylprednisolone (total dose, 80 mg) or placebo given every 4 hours starting 12 hours prior to planned extubation.
Significantly more patients in the placebo group than in the methylprednisolone group developed postextubation laryngeal edema (22% vs. 3%). The median time to laryngeal edema did not differ significantly between the two groups (10 minutes; interquartile range, 5–30 minutes vs. 30 minutes; IQR, 0–120 minutes). In logistic regression analysis, risk factors for pos…