Reviewed by Dr Simon Rowley, Dr Innes Asher, Dorothy Cooper
September 1996
Dose and Pharmacology Newborn Drug Protocol Index Newborn Services Home Page

Management of Ipratropium Administration





  1. Ensure nebuliser is in working order.
  2. Ipratropium is diluted in NS. Make up to 4ml.
  3. Ipratropium may be administered with budesonide and/or salbutamol if administration times coincide. It is not recommended to mix sodium cromoglycate (Intal) and ipratropium nebuliser solutions. Ensure total volume is made up to 4 ml with NS. Mix immediately prior to use. Discard if any turbidity or precipitation occurs.
  4. Nebulisation via a mask:
  1. Nebulisation via a ventilator circuit:
  1. Soaking in sodium hypochlorite solution is NOT recommended. Separate pieces. Rinse, drain dry on paper towel. Store dry in covered container.
  2. Change nebuliser weekly and PRN.

Observation and Documentation

  1. Assess for signs of adverse effects.
  2. Monitor SaO2 during administration of ipratropium.
  3. Continue to provide oxygen and ventilatory support as appropriate.
  4. Ensure ventilator pressures remain unchanged during nebulisation.
  5. Document patient response to therapy.


Selected References

1 Goss N, Skorodins MS. Anticholinergic, antimuscarinic bronchodilators. AmRevRespirDis 1984; 129:856-70.
2 Henry RL, Hiller EJ, Milner AD, Hodges IVG, Stokes GM. Nebulised ipratropium bromide and sodium cromoglycate in the first two years of life. Arch Dis Child 1984; 59:54-7.
3 Wilkie RA, Bryan MH. Effect of bronchodilators on airway resistence in ventilator dependent neonates with chronic lung disease. J Pediatr 1987; 111:278-82.
4 Brundage KL, Mohsini KG, Froeseab, Fisher JT. Bronchodilator response to ipratropium bromide in infants with bronchopulmonary dysplasia. Am Rev Respir Dis 1990; 142:113-42.