Study Participants
Study was performed in a 15-bed PICU over a period of 26 months
(February 2017 to March 2019) in a lower-middle income country. PICU is
part of a 1740 multi-specialty tertiary care teaching hospital (annual
admission, ~ 23,000), and admits~ 950 and ventilates ~ 400
patients per year. Parents or legal guardians gave written informed
consent before enrollment into the study. Eligibility criteria included
age >3 months and < 12 years, intubation
for > 48h, and anticipated to have their first
planned extubation during next 24h as in our previous study1. Patients with actual or potential poor airway
reflexes, Glasgow Coma Score (GCS) < 8, pre-existing
airway issues, previous tracheal intubation or tracheostomy, chronic
lung disease, contraindications for steroid, gastrointestinal bleeding,
hypertension (>95th centile),
hyperglycemia, steroid or chronic NSAID therapy were excluded. Patients
were also excluded if their extubation was deferred or they got
self-extubated.