Randomized Trial of Corticosteroids for Post-Extubation Aspiration

What this Trial Is About

Researchers are evaluating the effects of intravenous corticosteroids on laryngeal swelling and swallowing function in survivors of acute respiratory failure (ARF) who have documented laryngeal edema after being on mechanical ventilation. This randomized, placebo-controlled, double-blind trial is conducted across several major medical centers and enrolls patients from an existing longitudinal study who show laryngeal edema on fiberoptic endoscopic swallowing evaluation. The goal is to see if steroids can reduce swelling and improve swallowing quality of life after hospital discharge. Participants are randomly assigned to receive either 50 mg of methylprednisolone intravenously every six hours for four doses (total 200 mg) or a matching saline placebo on the same schedule. The study includes about 80 participants across five sites, with equal numbers in each group. The primary treatment period covers the first five days, during which swallowing function and laryngeal edema are closely monitored using the Revised Patterson Edema Scale and the Penetration-Aspiration Scale. During the study, participants undergo repeated fiberoptic endoscopic evaluations of swallowing to assess changes in laryngeal edema and swallowing safety from day 1 through day 5. Researchers will also measure quality of life related to swallowing and dietary habits one month after hospital discharge. Safety is monitored throughout, and all patients continue usual care. The total involvement includes the treatment period, follow-up assessments, and quality of life evaluations to understand the impact of corticosteroids on post-extubation dysphagia.

Corticosteroids for Post-Extubation Dysphagia