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Magnesium Sulphate Nebulization in Acute Severe Asthma

Teaching Hospital, JLN Medical College, Ajmer, India

PURPOSE: Management of acute severe asthma (ASA) is quite challenging. So, a continous research has been going on for new molecule that may add to available medications MgSO4 is a calcium antagonist which reduces movement of Ca2+ ion across cell membrane thus relieving bronchial constriction. It also reduces mucous glands secretions and release of histaimine by mast cells. Our study analysed the bronchodilating effects of MgSo4 alongwith safety profile in ASA.

METHOD: 71 pts were randomly allocated into 3 groups. Gp A (n=24) was nebulised with salbutamol, Gp B (n=26) with salbutamol & MgSo4 & Gp C (n=21) by MgSo4 alone. (MgSO4 7.5% w/v) Parameters measured PEFR, FEV1, FVC FEV1/FVC at baseline, 10 minute & 20 minute interval along with vital parameters and side effects.

RESULTS: In all three groups, we observed an increase in all parameters (PEFR, FEV1, FVC, FEV1/FVC) but insignificant (P>0.05). However, Mean % increase over baseline was quite significant (P<0.01) at 10 & 20 minute interval in Group B & Group C in whom MgSo4 was used. MgSo4 induced greater bronchodilation in those patients having baseline PEFR<50% [ASA] in contrast to salbutamol. No significant changes in vital parameters were noticed & side effects were self limiting.

CONCLUSION: MgSo4 induced greater bronchodilation in patients with ASA (PEFR<50%). No added side effects were noticed either alone or with salbutamol. Results are good & early but unsustainable. So may be used as an adjunct for standard treatment in management of ASA.

CLINICAL IMPLICATION: With early bronchodilating effects MgSO4 may be used in acute severe attacks of asthma to buy time till other standard Bronchodilatiors act. However, further clinical trials are needed to establish the optimum dose-response relationship.

DISCLOSURE: P. Dadhich, None.

This article has been cited by other articles:

				S Mohammed and S Goodacre Intravenous and nebulised magnesium sulphate for acute asthma: systematic review and meta-analysis Emerg. Med. J., December 1, 2007; 24(12): 823 - 830. [Abstract] [Full Text] [PDF]