Before deciding on steroids, there are many factors to be considered. Patient height and weight, ET tube size and medical history. For example, a person who is 5’ 0” with a size 8 ETT intubated for 2 days might not have a leak but be perfectly safe to extubate without steroids. Alterna...

Decadron 4-6 mg every 6 hours for 4 doses. I may repeat the cuff leak test several times and extubate sooner if a cuff leak develops. Also, if a patient is not fluid positive, a dose of Lasix IV is occasionally helpful. Finally, having the patient at between 45-90 degrees while in bed prior to extub...