Ket Keong, Liew
(2015)
Using isotonic magnesium sulfate nebulization as an adjuvant treatment for moderate acute exacerbation of
bronchial asthma (aeba) in adult comparing with salbutamol alone: a double blinded, randomised control
trial.
Masters thesis, Universiti Sains Malaysia.
Abstract
Objective
The aim of this study is to evaluate the efficacy of single dose nebulized magnesium
sulfate in augmenting bronchodilatory effect of salbutamol in acute asthma as compare
to salbutamol alone. In addition, we also observe for any significant reduction in total
treatment duration in this two study groups.
Methodology
This was a double blinded, randomized controlled trial, conducted in Emergency
Department of Hospital Universiti Sains Malaysia, Kelantan between 1st October 2013
and 1st October 2014. We enrolled a total of 120 patients with moderate acute
exacerbation of bronchial asthma, all the patients were then randomized into two
groups via block randomization technique. Group A (n=60) nebulized with salbutamol
only (5mg), Group B (n=60) nebulized with isotonic magnesium sulfate (7.5% w/v) plus
salbutamol (5mg). Blood pressure, pulse rate, respiratory rate, oxygen saturation and
peak expiratory flow rate (PEFR) of each patient were measured at baseline and at 20
minutes post-treatment. Total duration of treatment started from time of enrollment until
achievement of predicted PEFR > 80% was recorded.
Results
The 60 patients enrolled in each treatment arm had comparable baseline demographic
and clinical characteristics. At 20 minutes post-treatment, Group A and Group B showed statistically significant improvement in PEFR (100±61 L/min and 87±42 L/min
respectively, p value <0.001). Group B showed significant reduction of mean
respiratory rate and improvement in mean oxygen saturation (p value <0.001).
However, there were no statistically significant differences in means improvement of
PEFR and reduction of total duration of treatment between two groups. We did not
observe any adverse effect from treatment at all time.
Conclusion
In conclusion, the use of MgSO4 as an adjuvant to salbutamol nebulization in moderate
AEBA patient does not show any superiority in their therapeutic effect in comparing to
salbutamol alone. However, paired t-test done on group B population has shown the
feasible bronchodilatory property of MgSO4, it is able to bring about a statistically
significant decrease in respiratory rate and improvement in oxygen saturation. In future
study, we suggest a pilot study to be conducted to establish the dose-response
relationship of magnesium sulphate in the treatment of acute asthma before a larger,
multicentre trial is proposed.
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