Effect of nebulized budesonide in preventing postextubation complications in critically patients: A prospective, randomized, double-blind, placebo-controlled study

BACKGROUND: The efficacy of steroid administration in the prevention of postextubation complications in critical care remains controversial. The purpose of this study was to determine whether administration of nebulized budesonide in critically ill patients reduces the occurrence of postextubation airway complications. MATERIALS AND METHODS: This was a prospective, randomized, double-blind, placebo-controlled study. We prospectively followed up 70 adult patients in the intensive care unit who were intubated for more than 48 h. Patients received either nebulized budesonide (1 mg every 12 h; n = 35) or placebo (normal saline; n = 35) until 48 h after extubation. Then, the postextubation complications were assessed and recorded within 48 h of extubation. RESULTS: The incidence of respiratory distress was lower in budesonide group (8.6% vs. 31.4%, P = 0.017). Reintubation with mechanical support was necessary in 8.6% (3.35) of patients in the budesonide group and 31.4% (11.35) of patients in the placebo group (P = 0.017). CONCLUSION: Nebulized budesonide after extubation is effective in reducing the incidence of reintubation and respiratory distress in adult patients.