From the Research
Patients who have recently had a brain tumor removal can generally use BiPAP (Bilevel Positive Airway Pressure) therapy, but this decision should be made by their neurosurgeon and medical team based on their specific condition, considering the potential risks and benefits, as there is limited direct evidence on the use of BiPAP in this population, such as the case report described by 1. The timing of BiPAP initiation matters significantly, as in the immediate post-operative period (first few days to weeks), BiPAP may be contraindicated due to the potential increase in intracranial pressure or affect the surgical site. However, once the surgical site has adequately healed and the patient is stable, BiPAP can often be safely resumed or initiated if needed for conditions like sleep apnea or respiratory insufficiency. Some studies, such as 2, have investigated the optimal timing of post-operative anticoagulant prophylaxis, but do not provide direct evidence on the use of BiPAP in patients with recent brain tumor resection. Other studies, such as 3 and 4, have evaluated the effects of different agents on intraoperative brain relaxation and hemodynamics, but do not address the use of BiPAP in this population. An older study, 5, analyzed the necessity and duration of intensive care unit management for patients after brain tumor resection, but does not provide guidance on the use of BiPAP. Given the limited direct evidence, the decision to use BiPAP in patients with recent brain tumor resection should be made on a case-by-case basis, taking into account the individual patient's condition, the location and extent of surgery, presence of any cranial air, healing status, and overall neurological condition. If BiPAP is approved, the pressure settings might initially be lower than usual and gradually increased as tolerated. Patients should never restart BiPAP after brain surgery without explicit clearance from their neurosurgeon, as premature use could potentially lead to complications including cerebrospinal fluid leaks, pneumocephalus (air in the cranial cavity), or increased intracranial pressure.