Saudi Journal of Anaesthesia

ORIGINAL ARTICLE
Year
: 2017  |  Volume : 11  |  Issue : 1  |  Page : 9--14

Effect of nebulized budesonide on respiratory mechanics and oxygenation in acute lung injury/acute respiratory distress syndrome: Randomized controlled study


Hatem Saber Mohamed1, Mona Mohamed Abdel Meguid2 
1 Department of Anesthesia and Intensive Care Unit, Faculty of Medicine, Qena University Hospital, South Valley University, Qena, Egypt
2 Department of Clinical Pathology, Qena University Hospital, South Valley University, Qena, Egypt

Correspondence Address:
Hatem Saber Mohamed
Department of Anesthesia and Intensive Care Unit, Faculty of Medicine, Qena University Hospital, South Valley University, Qena 83523
Egypt

Background: We tested the hypothesis that nebulized budesonide would improve lung mechanics and oxygenation in patients with early acute lung injury (ALI) and/or acute respiratory distress syndrome (ARDS) during protective mechanical ventilation strategy without adversely affecting systemic hemodynamics. Methods: Patients with ALI/ARDS were included and assigned into two groups; budesonide group (30 cases) in whom 1 mg–2 ml budesonide suspension was nebulized through the endotracheal tube and control group (30 cases) in whom 2 ml saline (placebo) were nebulized instead of budesonide. This regimen was repeated every 12 h for three successive days alongside with constant ventilator settings in both groups. Hemodynamics, airway pressures, and PaO2/FiO2were measured throughout the study period (72 h) with either nebulized budesonide or saline. Furthermore, tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and interleukin-6 (IL-6) were analyzed serologically as markers of inflammation at pre- and post-nebulization sessions. Results: We found a significant difference between the two groups regarding PaO2/FiO2 (P = 0.023), peak (P = 0.021), and plateau (P = 0.032) airway pressures. Furthermore, TNF-α, IL-1β, and IL-6 were significantly reduced after budesonide nebulizations. No significant difference was found between the two groups regarding hemodynamic variables. Conclusion: Nebulized budesonide improved oxygenation, peak, and plateau airway pressures and significantly reduced inflammatory markers (TNF-α, IL-1β and IL-6) without affecting hemodynamics. Trial Registry: Australian New Zealand Clinical Trial Registry (ANZCTR) at the number: ACTRN12615000373572.


How to cite this article:
Mohamed HS, Meguid MM. Effect of nebulized budesonide on respiratory mechanics and oxygenation in acute lung injury/acute respiratory distress syndrome: Randomized controlled study.Saudi J Anaesth 2017;11:9-14


How to cite this URL:
Mohamed HS, Meguid MM. Effect of nebulized budesonide on respiratory mechanics and oxygenation in acute lung injury/acute respiratory distress syndrome: Randomized controlled study. Saudi J Anaesth [serial online] 2017 [cited 2021 Apr 21 ];11:9-14
Available from: https://www.saudija.org/article.asp?issn=1658-354X;year=2017;volume=11;issue=1;spage=9;epage=14;aulast=Mohamed;type=0