Using isotonic magnesium sulfate nebulization as an adjuvant treatment for moderate acute exacerbation of bronchial asthma (aeba) in adult comparing with salbutamol alone: a double blinded, randomised control trial

Objective The aim of this study is to evaluate the efficacy of single dose nebulized magnesium sulfate in augmenting bronchodilatory effect of salbutamol in acute asthma as compare to salbutamol alone. In addition, we also observe for any significant reduction in total treatment duration in this...

Full description

Saved in:
Bibliographic Details
Main Author: Ket Keong, Liew
Format: Thesis
Language:English
Published: 2015
Subjects:
Online Access:http://eprints.usm.my/39800/2/Dr_Liew_Ket_Keong_%28_Emergency_Medicine_%29-24_pages.pdf
Tags: Add Tag
No Tags, Be the first to tag this record!
id my-usm-ep.39800
record_format uketd_dc
spelling my-usm-ep.398002019-04-12T05:25:55Z Using isotonic magnesium sulfate nebulization as an adjuvant treatment for moderate acute exacerbation of bronchial asthma (aeba) in adult comparing with salbutamol alone: a double blinded, randomised control trial 2015 Ket Keong, Liew RC705-779 Diseases of the respiratory system Objective The aim of this study is to evaluate the efficacy of single dose nebulized magnesium sulfate in augmenting bronchodilatory effect of salbutamol in acute asthma as compare to salbutamol alone. In addition, we also observe for any significant reduction in total treatment duration in this two study groups. Methodology This was a double blinded, randomized controlled trial, conducted in Emergency Department of Hospital Universiti Sains Malaysia, Kelantan between 1st October 2013 and 1st October 2014. We enrolled a total of 120 patients with moderate acute exacerbation of bronchial asthma, all the patients were then randomized into two groups via block randomization technique. Group A (n=60) nebulized with salbutamol only (5mg), Group B (n=60) nebulized with isotonic magnesium sulfate (7.5% w/v) plus salbutamol (5mg). Blood pressure, pulse rate, respiratory rate, oxygen saturation and peak expiratory flow rate (PEFR) of each patient were measured at baseline and at 20 minutes post-treatment. Total duration of treatment started from time of enrollment until achievement of predicted PEFR > 80% was recorded. Results The 60 patients enrolled in each treatment arm had comparable baseline demographic and clinical characteristics. At 20 minutes post-treatment, Group A and Group B showed statistically significant improvement in PEFR (100±61 L/min and 87±42 L/min respectively, p value <0.001). Group B showed significant reduction of mean respiratory rate and improvement in mean oxygen saturation (p value <0.001). However, there were no statistically significant differences in means improvement of PEFR and reduction of total duration of treatment between two groups. We did not observe any adverse effect from treatment at all time. Conclusion In conclusion, the use of MgSO4 as an adjuvant to salbutamol nebulization in moderate AEBA patient does not show any superiority in their therapeutic effect in comparing to salbutamol alone. However, paired t-test done on group B population has shown the feasible bronchodilatory property of MgSO4, it is able to bring about a statistically significant decrease in respiratory rate and improvement in oxygen saturation. In future study, we suggest a pilot study to be conducted to establish the dose-response relationship of magnesium sulphate in the treatment of acute asthma before a larger, multicentre trial is proposed. 2015 Thesis http://eprints.usm.my/39800/ http://eprints.usm.my/39800/2/Dr_Liew_Ket_Keong_%28_Emergency_Medicine_%29-24_pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution Universiti Sains Malaysia
collection USM Institutional Repository
language English
topic RC705-779 Diseases of the respiratory system
spellingShingle RC705-779 Diseases of the respiratory system
Ket Keong, Liew
Using isotonic magnesium sulfate nebulization as an adjuvant treatment for moderate acute exacerbation of bronchial asthma (aeba) in adult comparing with salbutamol alone: a double blinded, randomised control trial
description Objective The aim of this study is to evaluate the efficacy of single dose nebulized magnesium sulfate in augmenting bronchodilatory effect of salbutamol in acute asthma as compare to salbutamol alone. In addition, we also observe for any significant reduction in total treatment duration in this two study groups. Methodology This was a double blinded, randomized controlled trial, conducted in Emergency Department of Hospital Universiti Sains Malaysia, Kelantan between 1st October 2013 and 1st October 2014. We enrolled a total of 120 patients with moderate acute exacerbation of bronchial asthma, all the patients were then randomized into two groups via block randomization technique. Group A (n=60) nebulized with salbutamol only (5mg), Group B (n=60) nebulized with isotonic magnesium sulfate (7.5% w/v) plus salbutamol (5mg). Blood pressure, pulse rate, respiratory rate, oxygen saturation and peak expiratory flow rate (PEFR) of each patient were measured at baseline and at 20 minutes post-treatment. Total duration of treatment started from time of enrollment until achievement of predicted PEFR > 80% was recorded. Results The 60 patients enrolled in each treatment arm had comparable baseline demographic and clinical characteristics. At 20 minutes post-treatment, Group A and Group B showed statistically significant improvement in PEFR (100±61 L/min and 87±42 L/min respectively, p value <0.001). Group B showed significant reduction of mean respiratory rate and improvement in mean oxygen saturation (p value <0.001). However, there were no statistically significant differences in means improvement of PEFR and reduction of total duration of treatment between two groups. We did not observe any adverse effect from treatment at all time. Conclusion In conclusion, the use of MgSO4 as an adjuvant to salbutamol nebulization in moderate AEBA patient does not show any superiority in their therapeutic effect in comparing to salbutamol alone. However, paired t-test done on group B population has shown the feasible bronchodilatory property of MgSO4, it is able to bring about a statistically significant decrease in respiratory rate and improvement in oxygen saturation. In future study, we suggest a pilot study to be conducted to establish the dose-response relationship of magnesium sulphate in the treatment of acute asthma before a larger, multicentre trial is proposed.
format Thesis
qualification_level Master's degree
author Ket Keong, Liew
author_facet Ket Keong, Liew
author_sort Ket Keong, Liew
title Using isotonic magnesium sulfate nebulization as an adjuvant treatment for moderate acute exacerbation of bronchial asthma (aeba) in adult comparing with salbutamol alone: a double blinded, randomised control trial
title_short Using isotonic magnesium sulfate nebulization as an adjuvant treatment for moderate acute exacerbation of bronchial asthma (aeba) in adult comparing with salbutamol alone: a double blinded, randomised control trial
title_full Using isotonic magnesium sulfate nebulization as an adjuvant treatment for moderate acute exacerbation of bronchial asthma (aeba) in adult comparing with salbutamol alone: a double blinded, randomised control trial
title_fullStr Using isotonic magnesium sulfate nebulization as an adjuvant treatment for moderate acute exacerbation of bronchial asthma (aeba) in adult comparing with salbutamol alone: a double blinded, randomised control trial
title_full_unstemmed Using isotonic magnesium sulfate nebulization as an adjuvant treatment for moderate acute exacerbation of bronchial asthma (aeba) in adult comparing with salbutamol alone: a double blinded, randomised control trial
title_sort using isotonic magnesium sulfate nebulization as an adjuvant treatment for moderate acute exacerbation of bronchial asthma (aeba) in adult comparing with salbutamol alone: a double blinded, randomised control trial
granting_institution Universiti Sains Malaysia
granting_department Pusat Pengajian Sains Perubatan
publishDate 2015
url http://eprints.usm.my/39800/2/Dr_Liew_Ket_Keong_%28_Emergency_Medicine_%29-24_pages.pdf
_version_ 1747820770407481344