pulmicort and Wounds-and-Injuries

Respiratory failure requiring endotracheal intubation accounts for a significant proportion of intensive care unit (ICU) admissions. Little attention has been paid to the laryngeal consequences of endotracheal intubation. Acute laryngeal injury (ALgI) after intubation occurs at the mucosal interface of the endotracheal tube and posterior larynx and although not immediately manifest at extubation, can progress to mature fibrosis, restricted glottic mobility and clinically significant ventilatory impairment. A recent prospective observational study has shown that >50% of patients intubated >24 hours in an ICU develop ALgI. Strikingly, patients with AlgI manifest significantly worse subjective breathing at 12 weeks. Current ALgI treatments are largely surgical yet offer a marginal improvement in symptoms.. The Institutional Review Board (IRB) Committee of the Vanderbilt University Medical Center has approved this protocol (IRB #171066). The findings of the trial will be disseminated through peer-reviewed journals, national and international conferences.. NCT03250975.

Topics: Acute Disease; Azithromycin; Budesonide; Double-Blind Method; Early Medical Intervention; Humans; Intensive Care Units; Intubation, Intratracheal; Larynx; Noninvasive Ventilation; Prospective Studies; Randomized Controlled Trials as Topic; Tennessee; Time Factors; Wounds and Injuries