OBJECTIVE: To probe into the effects of budesonide for inhalation on ventilator weaning patients with acute exacerbation of chronic obstructive pulmonary disease（COPD）. METHODS: A total of 270 COPD patients with ventilator weaning difficulties who received invasive mechanical ventilation in the respiratory department of the hospital from Jun. 2019 to Dec. 2021 were selected. And 100 healthy people who had physical examination in our hospital at the same time were extracted as the health group. Two hundred and seventy patients were divided into the budesonide group and control group according to random number table

with 135 cases in each group. All patients received routine treatment

the budesonide group was given budesonide for inhalation

the inhalation time was 10 min/time

every 12 hours for once. The spray atomizer was connected with the ventilator circuit

and inhaled continuously for 7 d. The ventilator weaning time

mechanical ventilation time

length of stay in ICU

the proportion of patients with re-intubation and the proportion of patients with noninvasive ventilation after weaning were compared between the budesonide group and the control group. Ventilator pressure

dynamic lung compliance were compared between the budesonide group and the control group at baseline

the 1 st

3 rd and 5 th day of treatment. The levels of inflammatory cytokines in the budesonide group

control group and healthy group were compared. RESULTS: After treatment

the ventilator weaning time [（4.69±1.61） d vs.（7.23±2.75） d

t=9.261

P<0.001]

mechanical ventilation time [（4.60±1.59） d vs.（7.16±2.82） d

t=9.261

P<0.001]

length of stay in ICU [（5.33±1.68） d vs.（6.27±1.73） d

t=4.529

P<0.001] in the budesonide group were significantly shorter than those in the control group

the proportion of patients with re-intubation in the budesonide group was significantly lower than that in the control group [14.8%（20/135） vs. 37.8%（51/135）

χ~2=18.364

P<0.001]

with statistically significant differences. On the 3 rd and 5 th day of treatment

the ventilator pressure in the budesonide group was significantly lower than that in the control group

and the dynamic lung compliance was significantly higher than that in the control group（P<0.001）. Compared with the control group

the levels of recombinant human chemokine 8（CXCL-8） and interleukin 6（IL-6） decreased significantly in the budesonide group on the 3 rd and 5 th day of treatment（P<0.001）

with statistically significant differences. CONCLUSIONS: Budesonide for inhalation shortens the ventilator weaning time of COPD patients with acute exacerbation of invasive mechanical ventilation

decreases the expression of CXCL8 and IL-6 in alveolar lavage fluid

and significantly improves dynamic lung compliance and ventilator indicators.