Effects of ipratropium bromide on the occurrence of postoperative respiratory complications in craniectomy patients with COPD

Abstract

Introduction: Postoperative pulmonary complications (PPCs) are common and associated with increased morbidity, mortality, and medical cost. They are gaining increasing concerns among patients receiving neurological surgery. Chronic obstructive pulmonary disease (COPD) affect a large section of whole population and is also one of the risk factors of PPCs in the perioperative setting. Ipratropium bromide is the inhalation solution for the treatment of COPD. Studies showed the perioperative nebulization of ipratropium bromide could increase the lung function and decrease the incidence of postoperative pneumonia in COPD patients underwent thoracic surgery. The purpose of this study is to investigate the effect of perioperative nebulization of ipratropium bromide on PPCs in COPD patients underwent neurosurgical surgery. Methods and analysis: This study is a multicenter retrospective study in China. Patients who meet the inclusion/exclusion criteria are selected from 7 neurosurgical centers in China. According to whether ipratropium bromide is used in perioperative period, the patients are divided into exposure group and control group. The primary outcome is the incidence of postoperative pneumonia. Secondary outcomes are unplanned intubation, postoperative mechanical ventilation ≥ 48 hours, respiratory failure, atelectasis, death, and length of stay. Ethics and dissemination: This study was approved by the ethics committee (EC) of the School of Public Health, Fudan University, Shanghai, China. Waived by the ethics committee, no written consent form was obtained since we used the registry data. The study results will be communicated via publication. Trial Registration Number: ChiCTR1900022552.

Risk Factors for Postoperative Pneumonia: A Case-Control Study

“…Numata T et al (15) have demonstrated that long-acting anticholinergic drugs and long-acting β2 receptor agonists can effectively reduce the rate of postoperative pulmonary complications in patients with COPD. Du Z et al (16) have further demonstrated that perioperative aerosol inhalation of ipratropium bromide can reduce the incidence of postoperative pneumonia in COPD patients undergoing thoracic surgery.…”

“…Pulmonary chronic inflammation in patients with COPD is a characteristic pathological change that will continue to destroy the alveolar wall septum and result in pulmonary interstitial fibrosis (9,14). Some previous studies have confirmed that preoperative treatment for COPD can reduce the incidence of postoperative pneumonia (15,16). Numata T et al (15) have demonstrated that long-acting anticholinergic drugs and long-acting β2 receptor agonists can effectively reduce the rate of postoperative pulmonary complications in patients with COPD.…”

Development of a nomogram for postoperative pneumonia after total hip or knee arthroplasty: a retrospective cohort study

“…Such factors may precipitate impaired lung ventilation functionality and damage to the mucociliary mechanism responsible for clearing pathogens from the airway [46][47][48][49] . Some studies have a rmed the e cacy of interventions aimed at curtailing the incidence of postoperative pneumonia in COPD patients 50,51 .Key interventions to diminish the risk of postoperative pneumonia include the preoperative prescription of long-acting anticholinergic drugs and β2 receptor blockers, intraoperative inhalation of ipratropium bromide, and implementing the use of an incentive spirometer postoperatively along with elevation of the bed head and upkeeping oral hygiene with chlorhexidine [50][51][52] .…”

Effects of Ipratropium Bromide Combined with Traditional Chinese Medicine Intervention on the Pulmonary Function and Psychological Status of Patients with Chronic Obstructive Pulmonary Disease

“…However, those abovementioned treatments can only play an auxiliary role but have no significant improvement on the patient's lung function, thereby requiring combination therapy for the symptoms [ 12 , 13 ]. Ipratropium bromide (IB) is a bronchodilator that can directly act on M receptors in the bronchial smooth muscle to inhibit airway remodeling and improve lung function [ 14 , 15 ].…”