Abstract
Background and aimsAsthma exacerbation is defined as an acute attack of shortness of breath with more than 25% decrease in morning peak flow compared to the baseline on 2 consecutive days, which requires immediate standard therapy. The majority of asthmatic patients are considered to be steroid-sensitive; however, corticosteroid-resistant asthma is a subset of asthma with poor response to corticosteroids and is responsible for frequent hospital admissions. In this study we aimed to compare the effects of two enhancing strategies, the nebulized ketamine and IV magnesium sulfate, in treatment of severe steroid resistant asthma.Materials and methodsThis double-blind randomized clinical trial was conducted on patients who presented to a referral clinic in Alborz, Iran. Using random allocation, patients were divided into two groups. The first group was treated with nebulized ketamine and the second group was treated with intravenous magnesium sulfate. Peak expiratory flow rates were assessed before the intervention, 30 and 60 min after the intervention and compared with the aid of SPSS software.ResultsThe Peak expiratory flow rates before the intervention, 30 min and 60 min after the intervention was statistically significantly different in both ketamine and magnesium sulfate groups. Peak expiratory flow rates change between 0 and 60 min were 29.4 and 15.2% in the ketamine and magnesium sulfate group respectively. Although the ketamine group showed much higher increase in mean PEFR compared to the MgSO4 groups, there was no statistically significant difference across both groups.ConclusionOur study concluded that combined with standard therapy, both ketamine and IV magnesium sulfate are effective agents in the improvement of PEFR in patients with acute severe asthma that failed to respond to traditional therapies. However, there were no statistically significant difference between the two groups.
Highlights
Asthma is a heterogenous chronic respiratory disease usually characterized as reversible airflow obstruction that presents with symptoms including shortness of breath, wheezing and cough caused by airway hyperresponsiveness to stimuli [1]
Our study concluded that combined with standard therapy, both ketamine and IV magnesium sulfate are effective agents in the improvement of Peak expiratory flow rate (PEFR) in patients with acute severe asthma that failed to respond to tradi‐ tional therapies
Asthma exacerbation is defined as an acute attack of shortness of breath with more than 25% decrease in morning peak flow compared to the baseline on 2 consecutive days, which requires immediate standard therapy [6]
Summary
Asthma is a heterogenous chronic respiratory disease usually characterized as reversible airflow obstruction that presents with symptoms including shortness of breath, wheezing and cough caused by airway hyperresponsiveness to stimuli [1]. Acute asthma exacerbation is account for most emergency department admissions and requires special attention [3]. It is considered as one of the major causes of morbidity and mortality among asthmatic patients which is associated with lifethreatening complications and variability in response to different therapies [4, 5]. Asthma exacerbation is defined as an acute attack of shortness of breath with more than 25% decrease in morning peak flow compared to the baseline on 2 consecutive days, which requires immediate standard therapy. In this study we aimed to compare the effects of two enhancing strategies, the nebulized ketamine and IV magnesium sulfate, in treatment of severe steroid resistant asthma
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