Use of dexamethasone during extubation in children admitted to the Neonatal Intensive Care Unit of San José Hospital, Bogota D.C. from January 2013 to June 2015

Uso de dexametasona durante la extubación en niños hospitalizados en la Unidad de Cuidado Intensivo Neonatal del Hospital de San José, Bogotá D.C., enero de 2013 a junio de 2015

Dexamethasone is useful during extubation in patients on prolonged intubation, as well as helping to reduce the need for re-intubation.
Objective: To evaluate the use of intravenous corticosteroids during extubation in newborns admitted to the Neonatal Intensive Care Unit of San José Hospital, Bogota DC.
Method: A retrospective, case series study was conducted by recording the characteristics of the use of dexamethasone for extubation, stridor frequency, re-intubation, and hospital stay, between January 2013 and June 2015. A descriptive analysis of the information collected is presented.
Results: A total of 316 patients, with a mean gestational age of 34 weeks (Inter-quartile range= 30.5–37), and 171 (54.2%) males, were included. There were 322 intubation events. Dexamethasone was used in 86 (26.7%) events. The first dose was given 7 days before birth in 24 (28.2%) of events, and 89 (68.6%) had prolonged intubation criteria. Dexamethasone was used in 66.2% of the prolonged intubations, and in 11.5% there was no clear indication. Of the events that received dexamethasone, 12 (13.2%) had stridor, 10 (11.6%) with a diagnosis of bronchopulmonary dysplasia, two suffered from a gastrointestinal bleed, and one with hyporeflexia. The frequency of re-intubation in the first 24 hours was 1.9% (6 events), of which 4 of them received dexamethasone.
Conclusions: The use of dexamethasone as prophylaxis in the extubation of patients admitted to the unit is common, however, there is a significant variation in its use. The frequency of adverse events is low.

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