Efficacy Evaluation of Nebulized Magnesium, as an Additional Complementary Treatment, in Clinical and Peak Flow Metric Improvements of Acute Asthma Attack: A Randomized Double-Blinded Clinical Trial

摘要

Background: Exacerbation of acute asthma attacks is a medical challenging problem that a?ects health systems all around the world.Accordingtothereports,acuteasthmahasallocatedabout1to12% ofadults’ referraltotheemergencydepartmentsbyitself. Thisstudyaimedtoinvestigatethee?ectof additionalnebulizedmagnesiumsulfate,asanadditionalcomplementarytreatment, on the management of acute asthma attack. Due to controversies and the fact that previous research has been unable to con?rm thebene?tsof routineuseof magnesiuminthecourseof treatmentof asthmaacutephase,thistrialwasconducted. Methods: Patients with a possible clinically suggested acute asthma attack, aged 18 to 65, were divided into two groups of interventionandcontrol. Aninitialpeak?owmeterevaluationatarrivalidenti?edtheseverityof patients’ asthmaattack. 148patients withmoderatetosevereattackswereincludedinthestudyintwogroups. Patientsof thecontrolgroupreceivedstandardasthma treatmentconsistingofnebulizedalbuterol2.5mgandnebulizedipratropiumbromide0.5mg,bothinminutes0,20,and40after arrival and oral single-dose prednisolone 50 mg at arrival. Patients of the case group received additional doses of nebulized magnesium sulfate 0.3 g in minutes 0, 20, and 40 after arrival in addition to the standard treatment performed on the control group. Theclinicalsettingof dyspneaBorgscaleinboththecaseandcontrolgroups,aswellastheirPEFRandFEV1values,wererecorded duringthetrialinminutes0,20,40,and60afterarrival. Chi-square,T-test,andMannWhitneytestwereappliedfordataanalysis. Results:Thestudywasconductedon148subjectswhoweredividedintotwogroupsof75and73ascaseandcontrolgroups,respectively. PEFRvaluesinminutes40and60afterarrivalwere295.04and336.2inthecasegroupand249.64and282.86inthecontrol group, andtherewasasigni?cantdi?erenceinthePEFRimprovementsbetweenthecaseandcontrolgroups(P< 0.001). Inaddition,FEV1inminutes40and60afterarrivalwasrespectively2.26and2.66inthecasegroupand1.88and2.23inthecontrolgroup. Thereweresigni?cantdi?erencesinFEV1improvementsbetweenthecaseandcontrolgroups(P< 0.001). Conclusions: Accordingtotheresultsof thisstudy,itcanbeconcludedthatadministrationof nebulizedmagnesiumsulfateasan adjunctivemedicationtothestandardtreatmentisbene?cialinthemanagementof moderatetosevereacuteasthmaattacksand signi?cantlyleadstobettercontrolof acuteattackinshortterm