Comparison of Efficacy of Nebulizing Budesonide and Intravenous Dexamethasone Before Extubation on Prevention of Post-extubation Complications in Intensive Care Unit Patients
Comparison of Efficacy of Nebulizing Budesonide and Intravenous Dexamethasone Before Extubation on Prevention of Post-extubation Complications in Intensive Care Unit Patients
The present study was aimed at investigating the efficacy of nebulizing Budesonide sin
 comparison with intravenous Dexamethasone before extubation in prevention of post-extubation
 complications amongst patients admitted in intensive care unit.

 In this double-blind randomized clinical trial study, 90 patients (age between 18 to 65) who
 are intubated (at least for 48 hours) and now are ready for extubation will be enrolled in
 the study after obtaining a written informed consent from their parents or guardians.

 The investigators divide our patients randomly into two equal groups.

 -In the budesonide group patients underwent a therapy with nebulizing Budesonide at a dose of
 1 mg diluted in 4 cc of sterile water for 20 minutes, one hour preceding extubation. After
 extubation patients received nebulizing budesonide via oxygen mask at the same dose every 12
 hours for 48 h.i In dexamethasone group intravenous dexamethasone was administered to patient
 at a dose of 0.15 mg/kg before extubation. After extubation, the administration of
 intravenous Dexamethasone continued at the same dose every 12 h. for 48 h.

 Another anesthesiologist who is unaware about kind of medication, will evaluate the patients
 for severity of stridor. We will record the vital sings and grade of stridor every 6 hour.
 Respiratory rate (RR), heart rate (HR), blood pressure (BP) and oxygen saturation (SPO2) were
 recorded for each patient immediately before aerosol administration (time 0) and at 30 and 60
 min; and 2,4,8,12,24,36 and 48 hrs. After extubation then the presence of stridor (heard with
 the aid of stethoscope) was recorded within 48 hr of extubation
Inclusion Criteria:

 1. Patients' age 18-65 years old

 2. Intubated for more than 48 hours after surgery

 3. Met the weaning criteria defined as respiratory rate < 30 breaths / min, negative
 tidal volume > 5 ml/kg ideal body weight, and shallow index (respiratory rate/tidal
 volume) < 105 breaths / min/L

 Exclusion Criteria:

 1. Any history of corticosteroid therapy in previous week

 2. Nasal or throat disease / surgery

 3. Pulmonary airway disease

 4. Gastrointestinal bleeding