From the Guidelines
Atrovent (Ipratropium) can be helpful in the treatment of Bronchopulmonary Dysplasia (BPD), as it has been shown to improve lung function in infants with chronic lung disease of infancy and childhood 1.
Key Points
- Bronchodilators, including anticholinergic agents like ipratropium, have become part of the standard therapeutic regimen for infants with moderate to severe BPD 1.
- Ipratropium bromide has been shown to affect bronchodilation in this population, with synergism noted between ipratropium bromide and salbutamol 1.
- Improvements in lung function have been demonstrated after treatment with bronchodilators, including increased dynamic compliance, increased specific airway conductance, and decreased airway resistance 1.
- However, bronchodilator responsiveness is not universal, and the effect of ipratropium may vary depending on the dose and individual patient response 1.
- Restricting therapy to symptomatic patients may be a reasonable course of action, as trials to date have not demonstrated that regular bronchodilator therapy improves long-term outcome 1.
From the Research
Efficacy of Atrovent (Ipratropium) in Treating Bronchopulmonary Dysplasia (BPD)
- The use of Atrovent (Ipratropium) in treating BPD has been studied, with some evidence suggesting its potential benefits 2.
- A study published in 1995 found that ipratropium bromide causes bronchodilation in ventilator-dependent infants with BPD in a dose-dependent fashion, with a decrease in respiratory resistance reaching a maximum of 20% at 175 mg 2.
- However, another study published in 1998 found that there was no statistically significant decrease in pulmonary resistance after ipratropium in BPD patients as a group, although individual patients may benefit 3.
- The 1996 study suggests that ipratropium bromide can be safely used in the management of acute bronchiolitis, but there are insufficient published data to determine its appropriate use in infants with BPD 4.
Limitations and Controversies
- The use of bronchodilators, including ipratropium, in BPD patients is not universally recommended, with some studies suggesting that routine administration may not be warranted in stable BPD patients 3, 5.
- A 2017 review highlights the lack of an evidence base for the use of various pharmacologic agents, including bronchodilators, in BPD management, and notes that some may do more harm than good 5.
- A 2023 review summarizes the current status of pharmacotherapy in BPD, including the limited number of drugs with consistent efficacy, but does not specifically address the use of ipratropium 6.