Background: Determining the optimal timing for extubation and weaning from mechanical ventilation is crucial. Various strategies have been proposed to minimize complications following extubation and weaning. This study examined the role of dexamethasone in mitigating post-extubation reactions in poisoned patients.
Method: This was a prospective randomized clinical study conducted in the ICU of poisoned patients during six months. Participants free of corticosteroid contraindications, were randomly assigned to a control group (no dexamethasone) or an intervention group (8 mg IV dexamethasone every 8 hours for at least three doses). Data collected included age, gender, toxic substance type, heart rate, oxygen saturation, blood pressure, and blood gases. Post-recovery assessments evaluated cuff test rate, breathing index, intubation duration, pneumonia/respiratory distress incidence, ICU stay length, reintubation, and overall outcomes. The data was analyzed using SPSS software.
Results: The control group consisted of 21 males (70%) and 9 females (30%). The Dexamethasone group consisted of 19 males (63.33%) and 11 females (36.67%). Blood gas results and vital signs revealed no notable changes before or after treatment. Lung compliance, the rapid shallow breathing index, and positive cuff tests showed improvement, though without significant differences. In both groups, 10% of patients (3 cases) required reintubation, and the incidence of respiratory distress or pneumonia was also 10%.
Conclusion: According to prior studies, minimal laryngeal edema following intubation in toxic patients indicates a low likelihood of inflammatory responses. Administering dexamethasone prophylactically is unlikely to significantly influence weaning or post-extubation reactions.