Nebulization by Isotonic Magnesium Sulphate Solution with Salbutamol Provide Early and Better Response as Compared to Conventional Approach (Salbutamol Plus Normal Saline) in Acute Exacerbation of Asthma in Children.
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Date
2014-07
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Abstract
Asthma attacks are serious respiratory problem that can be lethal when not treated appropriately. Till today the main
stay of therapy is short acting ß2-agonist. Unfortunately in acute asthma episodes this is not enough to relieve the
bronchospasm and reduce dyspnea. The shortcoming of ß2-agonist therapy has resulted in the use of a variety of
other treatment in the management of acute asthma. The use of magnesium sulphate is one of the recent treatment
options. This study was done to compare the efficacy of nebulized salbutamol with magnesium sulphate versus
salbutamol with normal saline in the treatment of acute exacerbation of asthma in children. This randomized
controlled trial was carried out among 60 patients with acute exacerbation of bronchial asthma fulfilling the inclusion
criteria, admitted in the department of Paediatrics, Mymensingh Medical College Hospital over a period of one year
from January 2009 to December 2009. They were distributed randomly, 30 patients received nebulized salbutamol
(0.15mg/kg; minimum dose 2.5mg) with 2.0 ml of isotonic magnesium sulphate solution and another 30 patients
received the same dose of salbutamol with 2.0 ml of normal saline on 3 occasions at 20 minute intervals. With single
dose of nebulization in the magnesium sulphate with salbutamol group, by 20 minute almost all 26 (86.7%) patients
achieved at least 60% of predicted PEFR. Within 20 minute from control group none could achieve 60% of predicted
PEFR. After second dose of nebulization control group started achieving 60% of predicted value. Regarding response
criteria, with second dose of nebulization, at 40 minute 16 (53.3%) patient from magnesium sulphate with salbutamol
group showed good response (PEFR>70% predicted). But within the first 40 minutes, none could show good
response in control group. With 3rd dose of nebulization all from magnesium sulphate group showed good response
but even at 60 minute, 5 (16.7%) patients in control group failed to be included as good responder. In conclusion,
nebulization by isotonic magnesium sulphate solution with salbutamol provide early and better response as compared
to conventional approach (salbutamol plus normal saline) in acute exacerbation of asthma in children.
Description
Keywords
Asthma, Magnesium sulphate, Salbutamol, PEFR
Citation
Akter T, Islam N, Hosque M A, Khanam S, Khan H A, Saha B A. Nebulization by Isotonic Magnesium Sulphate Solution with Salbutamol Provide Early and Better Response as Compared to Conventional Approach (Salbutamol Plus Normal Saline) in Acute Exacerbation of Asthma in Children.Faridpur Medical College Journal. 2014 July; 9(2): 61-67.