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

Abstract

Background: Exacerbation of acute asthma attacks is a medical challenging problem that affects health systems all around the world. According to the reports, acute asthma has allocated about 1 to 12% of adults’ referral to the emergency departments by itself. This study aimed to investigate the effect of additional nebulized magnesium sulfate, as an additional complementary treatment, on the management of acute asthma attack. Due to controversies and the fact that previous research has been unable to confirm the benefits of routine use of magnesium in the course of treatment of asthma acute phase, this trial was conducted. Methods: Patients with a possible clinically suggested acute asthma attack, aged 18 to 65, were divided into two groups of intervention and control. An initial peak flow meter evaluation at arrival identified the severity of patients’ asthma attack. 148 patients with moderate to severe attacks were included in the study in two groups. Patients of the control group received standard asthma treatment consisting of nebulized albuterol 2.5 mg and nebulized ipratropium bromide 0.5 mg, both in minutes 0, 20, and 40 after 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. The clinical setting of dyspnea Borg scale in both the case and control groups, as well as their PEFR and FEV1 values, were recorded during the trial in minutes 0, 20, 40, and 60 after arrival. Chi-square, T-test, and Mann Whitney test were applied for data analysis. Results: The study was conducted on 148 subjects who were divided into two groups of 75 and 73 as case and control groups, respectively. PEFR values in minutes 40 and 60 after arrival were 295.04 and 336.2 in the case group and 249.64 and 282.86 in the control group, and there was a significant difference in the PEFR improvements between the case and control groups (P < 0.001). In addition, FEV1 in minutes 40 and 60 after arrival was respectively 2.26 and 2.66 in the case group and 1.88 and 2.23 in the control group. There were significant differences in FEV1 improvements between the case and control groups (P < 0.001). Conclusions: According to the results of this study, it can be concluded that administration of nebulized magnesium sulfate as an adjunctive medication to the standard treatment is beneficial in the management of moderate to severe acute asthma attacks and significantly leads to better control of acute attack in short term.