The value of bronchodilators in patients with posttraumatic rib fractures (RIB-Inhalation): A multicenter prospective...

Rib fractures are common in patients with blunt thoracic trauma. The development of pneumonia increases the risk of mortality, and therefore prevention of pneumonia is one of the main goals of treatment. The aim of this study was to evaluate effects of bronchodilators on the occurrence of pneumonia in patients with posttraumatic rib fractures.

This multicenter prospective cohort study included patients between 21 September 2021 and 20 March 2024 admitted with 3 or more rib fractures and with a Glasgow Coma Scale score of 15. Occurrence of pneumonia was recorded and pulmonary function, level of thoracic pain, and symptoms indicative of bronchodilator side effects were collected on a daily basis during admission. Univariate analysis was performed to compare the 2 treatment groups. Repeated measure analysis was performed with correction for age, sex, and Injury Severity Score.

Overall, 119 patients were included, of whom 69 were in the bronchodilation group and 50 were in the no bronchodilation group. Patients had similar baseline and thoracic injury characteristics. Injury Severity Score was significantly greater in the bronchodilation group, although Abbreviated Injury Scale score of the chest was not significantly different. After multivariable analysis, there was no effect of treatment on occurrence pneumonia or other complications, hospital length of stay, pulmonary function, pain, or symptoms indicative of side effects of bronchodilators.

No beneficial clinical effects were found in patients treated with or without bronchodilators. Data from this study do not support the use of bronchodilators in patients with multiple rib fractures as proposed in current guidelines.