J Pediatr Intensive Care 2022; 11(01): 041-047
DOI: 10.1055/s-0040-1719044
Original Article

Use of Dexamethasone to Prevent Extubation Failure in Pediatric Intensive Care Unit: A Randomized Controlled Clinical Trial

Haroldo Teófilo de Carvalho
1   Department of Pediatrics, Botucatu School of Medicine, São Paulo State University, Botucatu, São Paulo, Brazil
José Roberto Fioretto
1   Department of Pediatrics, Botucatu School of Medicine, São Paulo State University, Botucatu, São Paulo, Brazil
Rossano Cesar Bonatto
1   Department of Pediatrics, Botucatu School of Medicine, São Paulo State University, Botucatu, São Paulo, Brazil
Cristiane Franco Ribeiro
1   Department of Pediatrics, Botucatu School of Medicine, São Paulo State University, Botucatu, São Paulo, Brazil
Joelma Gonçalves Martin
1   Department of Pediatrics, Botucatu School of Medicine, São Paulo State University, Botucatu, São Paulo, Brazil
Mário Ferreira Carpi
1   Department of Pediatrics, Botucatu School of Medicine, São Paulo State University, Botucatu, São Paulo, Brazil
› Author Affiliations
Funding None.


Extubation failure is a common event in intensive care units. Corticosteroids are effective in preventing failure in adults, but no consensus has been reached on this matter in pediatrics. We assessed the efficacy of intravenous dexamethasone in mechanically ventilated children and adolescents for more than 48 hours, with at least one risk factor for failure. Extubations were scheduled 24 hours in advance when possible, and patients were randomly assigned into two groups: one group received a loading dose followed by up to four doses of dexamethasone, and the other group received no corticosteroids. Need for reintubation and length of stay in the pediatric intensive care unit were similar in both groups, and frequency of reintubation was 12.9%.

Publication History

Received: 08 June 2020

Accepted: 24 September 2020

Article published online:
03 November 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
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