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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Ann+Thorac+Med
2014 ; 9
(2
): 77-80
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Magnesium for acute exacerbation of chronic obstructive pulmonary disease: A
systematic review of randomised trials
#MMPMID24791169
Shivanthan MC
; Rajapakse S
Ann Thorac Med
2014[Apr]; 9
(2
): 77-80
PMID24791169
show ga
The efficacy of magnesium sulphate in chronic obstructive pulmonary disease
(COPD) was assessed by conducting a systematic review of published randomized
clinical trials through extensive searches in MEDLINE and SCOPUS with no date
limits, as well as manual review of journals. Outcome measures varied depending
on route(s) of administration of magnesium sulphate and medications
co-administered. Risk of bias was evaluated and quality of evidence was graded.
Four (4) randomized trials were included. All trials had a moderate risk of bias
and were of average methodological quality. Magnesium sulphate given
intravenously did not seem to have an immediate bronchodilatory effect; however
it appears to potentiate the bronchodilatory effect of inhaled beta-2 agonists.
Increase in peak expiratory flow rate (PEFR) at 30 and 45 min was greater in
those who received magnesium sulphate compared to placebo (P = 0.03), although
the mean percentage change in PEFR was just 24%, without significant differences
in dyspnoea scores, hospital admission rates, or emergency department readmission
rates compared to placebo. Nebulized magnesium sulphate with salbutamol versus
nebulized salbutamol with saline placebo showed no significant differences is
forced expiratory volume in 1 s (FEV1) measured at 90 min after adjustment for
baseline FEV1 (P = 0.34) or differences in the need for hospital admission.
Combined inhalational and intravenous magnesium sulphate versus intravenous
saline placebo and nebulized ipratropium bromide were comparable in terms of
hospital admission, intubation and death, but the ipratropium bromide group
showed better bronchodilator effect and improvement in arterial blood gas
parameters. Overall, trial evidence for trial evidence for magnesium sulphate in
acute exacerbation of COPD is poor, and further well-designed trials are needed.
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