The Adjunctive Effect of Intravenous Magnesium Sulfate in Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Randomized Controlled Clinical Trial

Moradi, Elnaz Vafadar; Pishbin, Elham; Habibzadeh, Seyed Reza; Doluee, Morteza Talebi; Soltanifar, Azadeh

doi:10.1111/acem.14050

Cited by 3 publications

(5 citation statements)

References 9 publications

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“…Previous studies suggest that hypomagnesaemia may affect the hyperactivity of the airways. Indeed, magnesium normally relaxes bronchial smooth muscle by blocking calcium-dependent channels, and inhibits the release of acetylcholine from neuromuscular junctions [ 17 ]. The mechanisms through which magnesium levels may influence respiratory performance in COPD patients are still unclear, and those studies that have investigated the effects of magnesium supplementation on lung function have reported conflicting results.…”

Section: Resultsmentioning

confidence: 99%

“…Similar results were reported for intravenous administration of magnesium, which was found not to influence FEV1 in the stable phase of COPD [ 10 ]. The results regarding post-bronchodilator FEV1 are conflicting, since some studies found significant improvement in the magnesium group compared with the placebo group [ 17 , 19 , 20 ], while others found no significant change [ 10 – 13 , 21 , 22 ]. Although these studies are highly varied, it should be borne in mind that an improvement in FEV1 in response to β2-agonist has been often associated with intravenous magnesium administration.…”

Section: Resultsmentioning

confidence: 99%

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Clinical trial on the effects of oral magnesium supplementation in stable-phase COPD patients

et al. 2021

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Background and aims COPD is a common chronic condition in older age that impacts on daily activities and quality of life. Previous studies suggest that magnesium deficit in COPD patients affects bronco-obstruction, inflammation, and physical performance. We investigated whether oral magnesium supplementation in stable-phase COPD patients improves lung function, physical performance, and quality of life. Methods We conducted a double-blind randomized-controlled clinical study with 49 participants divided into two groups: one given 300 mg/day of magnesium citrate (n = 25) and the other one sachet/day of a placebo (n = 24). The following parameters were assessed at baseline and after 3 and 6 months: lung function (spirometry), physical performance (handgrip strength, lower limb strength, six-minute walk test), inflammation (e.g., C-reactive protein, CRP), disease-related symptoms, and quality of life (St George’s Respiratory Questionnaire, EuroQoL-5D, the Modified British Medical Research Council Questionnaire). Results Linear mixed models revealed significantly lower CRP values in the intervention group than in the placebo group at the 6 month follow-up (β = − 3.2, 95% CI − 6.0, − 0.4, p = 0.03). Moreover, the maximum work for flexion tended to increase in both groups between the 3 and the 6 month assessments, especially in the placebo group. No significant differences within and between groups over the study period were observed for the other parameters tested. Conclusions Although the established minimum sample size was not reached, our results suggests that oral magnesium supplementation may have a potential anti-inflammatory role. On the other hand, it does not seem to substantially influence lung function, physical performance, and quality of life in COPD patients. Trial registration The study is registered in clinicaltrial.gov (Trial Registration: NCT02680769, 13 June 2016, retrospectively registered).

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Clinical trial on the effects of oral magnesium supplementation in stable-phase COPD patients

et al. 2021

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“…Edwards et al revealed that in patients with AECOPD, using nebulized magnesium in combination with salbutamol, has no significant effect on FEV1 ( 10 ). Vafadar Moradi et al ( 9 ) showed that intravenous administration of 2.5 gr of magnesium sulfate significantly reduced the RR, PEFR and dyspnea severity scorein patients with AECOPD. However, in terms of SPO2, no significant differences was observed.…”

Section: Discussionmentioning

confidence: 99%

“…It has been previously shown that magnesium can potentiate the bronchodilatory effect of inhaled beta-2 agonist and has beneficial effects on the function of respiratory muscle (6)(7)(8)(9). In addition, due to its anti-inflammatory effects, it can theoretically potentiate resolution of acute airway inflammation and AECOPD (9)(10)(11). Several studies evaluated the effect of intravenous or inhalation magnesium sulfate for treatment of AECOPD, with conflicting results (2 6,10-11).…”

Section: Introductionmentioning

confidence: 99%

“…Recently, intravenous magnesium sulfate has been suggested as a potential adjunct therapy for AECOPD. It has been previously shown that magnesium can potentiate the bronchodilatory effect of inhaled beta-2 agonist and has beneficial effects on the function of respiratory muscle ( 6 – 9 ). In addition, due to its anti-inflammatory effects, it can theoretically potentiate resolution of acute airway inflammation and AECOPD ( 9 – 11 ).…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Intravenous Magnesium Sulphate as an Adjuvant in the Treatment of Acute Exacerbations of COPD in the Emergency Department: A Double-Blind Randomized Clinical Trial

Jahanian¹,

Khatir²,

Ahidashti³

et al. 2021

Ethiop J Health Sci

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BACKGROUND፡ Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are serious complications that often require immediate intervention in an emergency department (ED). The aim of this study was to investigate the effect of intravenous magnesium sulphate as an adjuvant in the treatment of AECOPD in the ED.METHODS: In a double-blind, randomized clinical trial, a total of 60 patients with AECOPD presenting to the ED of Imam Khomeini Hospital in Sari, Iran, were included. The study was conducted between September 2016 and February 2018. Eligible patients were randomly allocated into two groups of intervention and control. Patients in the intervention and control groups received intravenous infusion of magnesium sulfate (2 gr) or normal saline over 30 minutes, respectively. For all patients, Borgdyspnea score, forced expiratory volume in one second (FEV1) result and clinical variables of interest were evaluated before the beginning of the intervention, and also 45 minutes and 6 hours after the commencement of intervention.RESULTS: Regardless of time of evaluation, pulse rate (PR), respiratory rate (RR) and Borg score in intervention group was lower than control group. Also, FEV1 and SPO2 were greater in intervention group compared to control group. However, these differences were not statistically significant (between-subject differences or group effect) (p<0.001). The trends of FEV1, SPO2, PR, RR and Borg score were similar between two groups of study (no interaction effect; P>0.05).CONCLUSION: According to the results of this study, it seems that using intravenous magnesium sulfate has no significant effect on SPO2, FEV1, RR, and PR of patients with AECOPD who presented to ED.

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Magnesium sulfate for acute exacerbations of chronic obstructive pulmonary disease

Aye

Naing

2022

Cochrane Database of Systematic Reviews

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The Adjunctive Effect of Intravenous Magnesium Sulfate in Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Randomized Controlled Clinical Trial

Cited by 3 publications

References 9 publications

Clinical trial on the effects of oral magnesium supplementation in stable-phase COPD patients

Clinical trial on the effects of oral magnesium supplementation in stable-phase COPD patients

The Effect of Intravenous Magnesium Sulphate as an Adjuvant in the Treatment of Acute Exacerbations of COPD in the Emergency Department: A Double-Blind Randomized Clinical Trial

Magnesium sulfate for acute exacerbations of chronic obstructive pulmonary disease

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