Comparison of Nebulized Budesonide and Intravenous Dexamethasone Efficacy on Tracheal Tube Cuff Leak in Intubated Patients admitted to Intensive Care Unit

Abstract

Background: Tracheal intubation is a common action in intensive care unit (ICU); however, it may cause laryngeal edema or laryngotracheal injury which leads to edema. The cuff-leak test is usually done to define the upper airway patency. Considering the point that laryngeal edema would be treated by anti-inflammatory agents, our aim was to evaluate the impact of nebulized budesonide on ICU patients' relief and comparison between nebulized budesonide efficacy and intravenous (IV) dexamethasone. Materials and Methods: In our clinical trial, 270 intubated patients from ICU were randomly selected and divided into three groups (each group was included 90 patients) as follows: IV dexamethasone, nebulized budesonide, and placebo group. All the patients were monitored at 0, 12, 24, 36, and 48 h of starting follow-up. Hemodynamic parameters and cuff-leak ratio were measured and data were analyzed using SPSS (ver. 20). Results: Our findings revealed that dexamethasone and budesonide treatment approaches were beneficial for an increase of cuff-leak volume (P 0.05). Conclusion: Our findings demonstrated that the use of budesonide and dexamethasone is beneficial in intubated ICU patients, and the above-mentioned approaches can reduce the complications of tracheal intubation. Furthermore, budesonide could be a trustworthy substitute treatment strategy instead of IV dexamethasone.

Keywords

• Cuff-leak ratio
• intravenous dexamethasone
• laryngeal edema
• nebulized budesonide
• tracheal intubation