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

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.

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).

Our findings revealed that dexamethasone and budesonide treatment approaches were beneficial for an increase of cuff‑leak volume (P < 0.001). Furthermore, the superiority of mentioned methods in patients’ relief was significant compared with placebo group (P < 0.001). Moreover, hemodynamic parameters were not altered and were within the normal range in both dexamethasone and budesonide groups (P > 0.05).

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.