Abstract
Intravenous magnesium sulphate (MgSO4) has been tried in the emergency department treatment of asthma since the mid-1980s, but published reports vary as to its efficacy. The literature suggests that it may be effective in the more severely ill asthmatic. We evaluated i.v. MgSO4 in adult asthmatics having a moderate to severe exacerbation. The study was performed in a convenience sample of adult asthmatics between the ages of 18 and 55 presenting to the emergency department with a peak expiratory flow (PEF) of < 100 l/min or < 25% of predicted flow. Patients received either 2.0 grams of MgSO4 or placebo in a randomized, double-blind fashion. All patients received inhaled bronchodilators and i.v. steroids. Outcome variables were: improvement in PEF, subjective respiratory distress as measured by the Borg dyspnoea scale (BDS) and hospital admission. The first visits of 42 patients presenting with acute asthma exacerbations were evaluated, 18 receiving MgSO4 and 24 receiving placebo. The t = 60 peak flow in the MgSO4 group was 174 l/min versus 212 l/min in placebo, p = 0.04. Controlling for age, heart rate, initial PEF and initial BDS in ordinal logistic regression, the t = 60 Borg scale of subjective dyspnoea had an odds ratio of ...Continue Reading
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