Abstract

Abstract Background Asthma exacerbations are acute or subacute episodes of breathlessness, cough, wheezing, and chest tightness, or any combination of these symptoms. Exacerbations are associated with airways obstruction that should be documented and quantified by PEF or FEVI measurement. Early treatment of asthma exacerbations should be the best strategy for management. Objective To compare fast effectiveness between the nebulized salbutamol with normal Saline and salbutamol with magnesium sulphate by nebulizer in treatment of acute asthma. Patients and Methods: This two armed prospective randomized study included 60 patients admitted to Intensive Care Unit, Ain Shams University Hospital from July 2019 to July 2020. Patients were randomized into two equal groups: group A which included 30 patients on salbutamol nebulization and group B that included 30 patients on combination of salbutamol and magnesium sulphate. Results systolic blood pressure, diastolic Bl. P and FEVI were higher among salbutamol group (A) than combination group (B), meanwhile HR and 02% were significantly lower among group A than group B with statistically insignificant differences (p > 0.05). Group A had significantly higher mean of RR (20±1.33) than group B (17.2 ±1.14) (p < 0.001). Also, Group A had significantly higher mean of PEFR (217.5 ±74.72) than group B (125±78.05) (p = 0.014). There were significant differences between in group A in HR and 02% before and after TTT (p < 0.05). With treatment, the pulse rate rose significantly (p = 0.010) but there was no significant change in the systolic or diastolic blood pressure. The 02% rose significantly (p<O.001). There were significant differences between in group B in RR, HR, 02%, PEFR and FEVI before and after TTT (p < 0.05). With treatment, the respiratory rate declined significantly (p < 0.001), the pulse rate declined significantly (p = 0.013) in but there was no significant change in the systolic or diastolic blood pressure. The PEFR rose significantly (p = 0.001) and also the 02% rose significantly (p < 0.001). Conclusion Nebulized MgS04, either alone or combined with salbutamol, has a clinically significant bronchodilator effect in acute asthma. This suggests that a combination of MgS04 and salbutamol may be the best choice for the management of acute exacerbations of asthma.

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