Effectiveness and Safety of Nasal Herbal Steam Therapy for Post-Extubation Respiratory Symptoms: A Methodology of Pragmatic Randomized Controlled, Parallel Grouped Study

Post-extubastion respiratory symptoms (PERS) are a common sequelae of endotracheal intubation, impeding postoperative recovery. Despite the widespread use of prophylactic corticosteroids and symptomatic management, these approaches have limitations in alleviating PERS. In this study, we aim to evaluate the efficacy and safety of nasal herbal steam therapy (NHST), a traditional Korean medicine intervention, in managing PERS among patients with thyroid cancer following endotracheal intubation. In this pragmatic, parallel-group randomized controlled trial, 66 post-thyroidectomy patients with thyroid cancer who underwent endotracheal intubation will be randomly assigned in a 1:1 ratio to either the NHST group or the standard care group. The intervention group will receive personalized NHST for 5 consecutive days, whereas the control group will follow conventional postoperative care protocols. The primary endpoint is the change in Wisconsin Upper Respiratory Symptom Survey scores from baseline to day 5. Secondary endpoints included patient-reported symptom relief, safety assessments, and adherence rates. By investigating the therapeutic potential of NHST, this study will establish its role as a non-invasive, adjunctive intervention for improving intubation-related complications, potentially contributing to broadening integrative treatment strategies and optimizing recovery outcomes for patients with PERS. The study will be conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of CHA Ilsan Medical Center (ICHA 2024-011-006, date of approval 2024-09-04).