Effects of the budesonide nebulization in the treatment of mechanically ventilated patients with chronic obstructive pulmonary disease_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 CUI Zhaobo , GAO Xiuling , LIU Shuhong , LI Suyin , ZHANG Juxiang

Department of Respiratory Medicine，Harrison International Peace Hospital.Hengshui，Hebei，053000，ChinaCorresponding author：cuizhaobo，E-mail：cuizhaobo@yahoo.com.cn;

Corresponding author：

CUI Zhaobo, Email: cuizhaobo@yahoo.com.cn

Keywords：

Budesonide; Chronic obstructive puhnonary disease; Respiratory failure; Mechanical ventilatio

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Objective To explore the effect of budesonide nebulization in the treatment of mechanically ventilated patients with chronic obstructive pulmonary disease(COPD).Methods A total of 25 intubated and ventilated COPD patients complicated with respiratory failure was randomly divided into two groups.The control group consisted of 12 patients received salbutamol nebulization on the routine treatment.The budesonide group consisted of 13 patients received budesonide plus salbutamol nebulization on the routine treatment.Variables such as tumor necrosis factor-α(TNF-α) and interleukin-8(IL-8) in the bronchoalveolar lavage fluid(BALF) ， incidence of ventilation-associated lung injury(VALI) ， days of mechanical ventilation ，， days of hospitalization and survival rate were measured and compared.Results The survival rate and incidence of VALI were not different significantly between the two groups.However ， the levels of TNF-α and IL-8 in BALF of the control patients were significantly lower than those in the budesonide group[ （ 1.2±0.2 ） mg/L vs （ 1.5±0.4 ） mg/L ，（ 85.7±26.5 ）（ 125.6±30.4 ）， both P lt;0.05).And the days of mechanical ventilation and hospitalization were statistically shorter in the budesonide group compared with the control group[ (7.2±2.5 ） d vs （ 10.5±6.2 ） d ， (10.5±4.7 ） d vs (15.8±6.6 ） d ， both P lt;0.05].Conclusion Our data suggest that nebulization of budesonide can suppressed the pulmonary inflammation and decreased days of the mechanical ventilation and hospitalization in mechanically ventilated COPD patients.

Citation： CUI Zhaobo,GAO Xiuling,LIU Shuhong,LI Suyin,ZHANG Juxiang. Effects of the budesonide nebulization in the treatment of mechanically ventilated patients with chronic obstructive pulmonary disease. Chinese Journal of Respiratory and Critical Care Medicine, 2008, 08(4): 268-270. doi: Copy

1.	2 Sposato B, Mariotta S, Palmiero G, et al. Oral corticosteroids can improve nocturnal isolated hypoxemia in stable COPD patients with diurnal PaO2> 60 mmHg. Eur Rev Med Pharmacol Sci, 2007,11:365-372.
2.	3 刘春涛，冯玉麟. 慢性阻塞性肺疾病全球创议，慢性阻塞性肺疾病诊断、管理和预防袖珍指南(2006年修订版)，中国呼吸与危重监护杂志，2007，6：230-237.
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4.	8 徐峻，蔡柏蔷.浅析2006年慢性阻塞性肺疾病全球创议修订版.国际呼吸杂志，2007，27：161-165.
5.	Quon BS, Gan WQ, Sin DD. Contemporary management of acute exacerbations of COPD: a systematic review and meta-analysis. Chest, 2008，133:756-766.
6.	Wilkinson TM, Donaldson GC, Hurst JR, et al. Early therapy improves outcomes of exacerbations of COPD.Am J Respir Crit Care Med,2004,169:1298-1303.
7.	MacNee W. Acute exacerbations of COPD.Swiss Med Wkly,2003,133:247-257.
8.	MacNee W. Pulmonary and systemic oxidant/antioxidant imbalance in chronic obstructive pulmonary disease. Proc Am Thorac Soc, 2005,2:50-60.
9.	Vlahakis NE, Schroeder MA, Limper AH, et al.Stretch induces cytokine release by alveolar epithelial cells in vitro. Am J Physiol,1999,277:167-173.
10.	Held HD , Boettcher S , Hamann L, et al.Ventilation-induced chemokine and cytokine release is associated with activation of nuclear factor κB and is blocked by seeroids. Am J Respir Crit Care Med, 2001, 163:711-716.

1. 2 Sposato B, Mariotta S, Palmiero G, et al. Oral corticosteroids can improve nocturnal isolated hypoxemia in stable COPD patients with diurnal PaO2> 60 mmHg. Eur Rev Med Pharmacol Sci, 2007,11:365-372.
2. 3 刘春涛，冯玉麟. 慢性阻塞性肺疾病全球创议，慢性阻塞性肺疾病诊断、管理和预防袖珍指南(2006年修订版)，中国呼吸与危重监护杂志，2007，6：230-237.
3. 4 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南.中华内科杂志,2002， 41:640-646.
4. 8 徐峻，蔡柏蔷.浅析2006年慢性阻塞性肺疾病全球创议修订版.国际呼吸杂志，2007，27：161-165.
5. Quon BS, Gan WQ, Sin DD. Contemporary management of acute exacerbations of COPD: a systematic review and meta-analysis. Chest, 2008，133:756-766.
6. Wilkinson TM, Donaldson GC, Hurst JR, et al. Early therapy improves outcomes of exacerbations of COPD.Am J Respir Crit Care Med,2004,169:1298-1303.
7. MacNee W. Acute exacerbations of COPD.Swiss Med Wkly,2003,133:247-257.
8. MacNee W. Pulmonary and systemic oxidant/antioxidant imbalance in chronic obstructive pulmonary disease. Proc Am Thorac Soc, 2005,2:50-60.
9. Vlahakis NE, Schroeder MA, Limper AH, et al.Stretch induces cytokine release by alveolar epithelial cells in vitro. Am J Physiol,1999,277:167-173.
10. Held HD , Boettcher S , Hamann L, et al.Ventilation-induced chemokine and cytokine release is associated with activation of nuclear factor κB and is blocked by seeroids. Am J Respir Crit Care Med, 2001, 163:711-716.

Chinese Journal of Respiratory and Critical Care Medicine

Effects of the budesonide nebulization in the treatment of mechanically ventilated patients with chronic obstructive pulmonary disease

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