Effects of ipratropium bromide on the occurrence of postoperative respiratory complications in craniectomy patients with COPD: A nationwide multicenter retrospective study

Medicine (Baltimore). 2020 Jun 26;99(26):e20836. doi: 10.1097/MD.0000000000020836.

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.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Bronchodilator Agents / standards
  • Bronchodilator Agents / therapeutic use
  • Chi-Square Distribution
  • China / epidemiology
  • Craniotomy / adverse effects*
  • Craniotomy / methods
  • Dyspnea / drug therapy*
  • Female
  • Humans
  • Ipratropium / standards*
  • Ipratropium / therapeutic use
  • Male
  • Middle Aged
  • Postoperative Complications / drug therapy
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control*
  • Propensity Score
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Pulmonary Disease, Chronic Obstructive / drug therapy
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Retrospective Studies

Substances

  • Bronchodilator Agents
  • Ipratropium