What risk factors predict post-extubation laryngeal edema?

Independent risk factors: intubation >6 to 7 days (2x risk), female sex (2x risk), tube/trachea diameter ratio >45% (2x risk), failed cuff leak test (<110 mL: 4x risk), traumatic intubation, prior failed extubation, obese/short neck anatomy, ETT movement/self-extubation attempts, and reintubation (edema from repeat trauma).

What intervention reduces post-extubation stridor requiring reintubation?

Prophylactic corticosteroids for high-risk patients (failed cuff leak test or intubation >7 days): methylprednisolone 20 mg IV q4h x 4 doses starting 12h before extubation reduces stridor from 22% to 3% (NNT 5). Heliox (70:30 He:O2) can temporize stridor after extubation while steroids take effect. Reintubation within 24h: consider surgical airway evaluation.

Post-Extubation Stridor Risk Score

Calculate risk of post-extubation laryngeal edema requiring reintubation based on cuff leak volume, intubation duration, age, sex, and tube-to-trachea size ratio.

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Cuff Leak Test

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Post-Extubation Stridor Risk Score

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Frequently Asked Questions

What risk factors predict post-extubation laryngeal edema?

What intervention reduces post-extubation stridor requiring reintubation?