What is the role of decadron in preventing post extubation stridor?

The podcast discusses the role of steroids in preventing post-extubation stridor and reducing reintubation risk, primarily referencing a CHESS 2001 study by Maureen Mead. While steroids are shown to reduce post-extubation stridor in children by about 40%, their effect on reintubation rates in children is unclear, with conflicting study results. For adults, reintubation due to upper airway obstruction is infrequent, and trials on steroid efficacy have been uninformative due to low event rates, suggesting that large-scale trials may not be resource-efficient. The discussion also touches on a broader evaluation of corticosteroid use in the ICU, highlighting concerns about increased infection rates and other complications, and concluding that the benefits of steroids for preventing post-extubation stridor and reintubation in adults do not outweigh the risks.