Extubation Management / Cuff Leak

LARYNGEAL EDEMA:


Incidence of postextubation laryngeal edema requiring reintubation is low (<5%) 

If negative cuff leak then start methylprednisolone 20 mg IV q4h x 4 doses prior to extubation 

Alt: methylprednisolone 40 mg IV x1 dose 4 hours prior to extubation 

*conflicting data regarding efficacy of glucocorticoids at preventing post-extubation stridor

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