Journal of Isfahan Medical School

Journal of Isfahan Medical School

The Role of Dexamethasone in Facilitating the Weaning Process for Poisoned Patients

Document Type : Original Article(s)

Authors
Shayesteh Ashrafi Esfahani 1
Maral Ramezani 2
Shahin Shadnia 3
Mitra Rahimi 3
Babak Mostafazadeh 3
Mahnaz Dahdasti Azandaryani 3
Peyman Erfan Talab Evini 3
1 School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Department of Pharmacology, Traditional and Complementary Medicine Research Center School of Medicine, Arak University of Medical Sciences, Arak, Iran
3 Toxicological Research Center, Excellence Center & Department of Clinical Toxicology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
10.48305/jims.v44.i875.1562
Abstract
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.

Highlights

Shayesteh Ashrafi Esfahani: Google Scholar , PubMed

Maral Ramezani: Google Scholar , PubMed

Shahin Shadnia: Google Scholar , PubMed

Mitra Rahimi: Google Scholar , PubMed

Babak Mostafazadeh: Google Scholar , PubMed

Peyman Erfan Talab Evini: Google Scholar , PubMed

Keywords
Dexamethasone
Airway Extubation
Lung compliance
Respiration Artificial
Poisoning
Ventilator Weaning
Subjects
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Journal of Isfahan Medical School
Volume 44, Issue 875
2nd Week,October
September and October 2026
Pages 1562-1569

  • Receive Date 27 July 2025
  • Accept Date 23 May 2026