{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:05:23Z","timestamp":1790661923073,"version":"4.1.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017695","name":"Health Commission of Hunan Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017695","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002767","name":"Department of Science and Technology of Hunan Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002767","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to determine whether budesonide inhalation suspension (BIS) diffuses through polyvinyl chloride (PVC) endotracheal tube (ETT) cuffs and whether intracuff budesonide attenuates the acute subglottic injury during endotracheal intubation (ETI) in a rabbit model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      <jats:italic>in vitro<\/jats:italic>\n                      , high-performance liquid chromatography was used to quantify trans-cuff diffusion of budesonide from 2.5-mm-ID PVC ETT cuffs. For the\n                      <jats:italic>in vivo<\/jats:italic>\n                      study, 32 New Zealand White rabbits were allocated to four groups (\n                      <jats:italic>n<\/jats:italic>\n                      =8): control (Con), air-inflated cuff (Air), normal saline-inflated cuff (NS), and BIS-inflated cuff (Bud). Intubated rabbits underwent 12\u2005h of ETI at an intracuff pressure of 22 mmHg. Subglottic tissues were harvested immediately after extubation for histological and immunofluorescence analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Budesonide diffusion across PVC ETT cuffs was temperature-dependent during the first 12\u2005h and continued at 37\u00b0C for at least 14 days.\n                      <jats:italic>In vivo<\/jats:italic>\n                      , all ETI groups developed acute subglottic histological injury. Compared with the Air and NS groups, the Bud group had lower IL-1\u03b2, IL-6, and TNF-\u03b1 fluorescence intensities (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05), whereas the measured histological outcomes and CD86\/CD206 levels did not differ significantly among the ETI groups. No significant differences were observed between the Air and NS groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Budesonide diffuses across PVC ETT cuffs, and intracuff BIS was associated with lower subglottic IL-1\u03b2, IL-6, and TNF-\u03b1 fluorescence intensities during a 12-hour acute ETI model. The findings do not establish prevention of histological injury and require confirmation in longer-duration pharmacokinetic and outcome studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1886065","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:48:30Z","timestamp":1790660910000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Trans-cuff budesonide delivery and its effects on endotracheal intubation-induced subglottic injury"],"prefix":"10.3389","volume":"14","author":[{"given":"Yi","family":"Zou","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Nanfang Hospital, Southern Medical University","place":["Guangzhou, China"]},{"name":"Department of Anesthesiology, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University)","place":["Changsha, 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of Pharmacy, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University)","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Zhong","sequence":"additional","affiliation":[{"name":"Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University)","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Huang","sequence":"additional","affiliation":[{"name":"Hunan Provincial Key Laboratory of Pediatric Respirology, Pediatric Medical Center, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University)","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaoyin","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Hunan 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