Role of Nebulized Magnesium Sulfate in Acute Exacerbations of Chronic Obstructive Pulmonary Disease
Keywords:
AECOPD, Magnesium Sulfate, Peak Expiratory Flow Rate.Abstract
Background: Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) is a common cause of hospitalization, leading to rises in mortality and morbidity in low- and middle-income countries (LMICs), including Bangladesh. Therapeutic benefits have been seen in acute Asthma patients nebulized with magnesium sulfate. So the aim of this study was to investigate the role of nebulized magnesium sulfate as an adjuvant treatment in AECOPD.
Objectives: To evaluate the role of nebulized magnesium sulfate in the management of AECOPD.
Methods: It was a randomized controlled trial where 324 subjects were enrolled and allocated into two groups with 162 in each group. Then each group received either 2.5 mg salbutamol mixed with 2.5 ml magnesium sulfate or 2.5 mg salbutamol mixed with 2.5 ml isotonic normal saline on three occasions at 30-minute intervals via nebulizer. The role of magnesium sulfate was investigated by measuring PEFR (Peak Expiratory Flow Rate) as the primary outcome parameter at 30, 60, and 90 minutes after nebulization. The secondary outcome measure was to assess Intensive Care Unit (ICU) admission for ventilator support, mortality, changes in respiratory rate and oxygen saturation.
Results: The mean PEFR in the magnesium sulfate group at 30, 60 and 90 minutes were 91.36±16.66, 129.44±33.13 and 163.78 ±66.30. Also mean PEFR in normal saline group at 30, 60 and 90 minutes were 72.16±16.66, 85.49±24.80 and 97.81±33.66. PEFR was higher in the magnesium group than in the normal saline group (p < 0.001), which was statistically significant. A total of 15.4% of patients were admitted to the ICU, and 4.9% died among patients nebulized with magnesium sulfate. But 27.2% were admitted to the ICU and 13% died among patients nebulized with normal saline. The p-value was <0.0146, which was statistically significant. Conclusions: Nebulized magnesium as an adjuvant to bronchodilators in the setting of AECOPD resulted in significant improvement of PEFR.
J MEDICINE 2026; 27: 62-66
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