Evaluation the role of nebulized magnesium sulfate in the treatment of severe exacerbation of asthma in children & adolescence

Abstract

Asthma may arise as a result of interaction between multiple genetic and environment factors this is the case with most of called allergic asthma that occurs in patients who exhibit acute immediate hypersensitivity responses to define environmental allergen. Treatment of asthma is largely palliative and includes patient's education, avoid or control asthma triggers, immunotherapy (hyposensitization) and drug therapy. The present study aim to evaluate the role of nebulized magnesium sulfate in the treatment of severe exacerbation of asthma. A cross sectional comparative study carried out on all patients with severe exacerbation of asthma admitted to the emergency unit at Al- Sherqat general hospital at a period between March & August 2007. 80 patients with severe asthma exacerbation 44 male and 36 female their age between 5 to 19 years. All 80 patients to two major groups. Group I. 40 patients received nebulized salbutamol alone 0.15mglkg mg and after 15 min full clinical assessment of improvement done including the PEFR, respiratory rate and heart rate. Group II. 40 patients received nebulized sulbutamol 0.15mg/kg mg with nebulized magnesium sulfate o.15ml/kg. Also full clinical assessment of improvement done after 15min including the PEFR, respiratory rate and heart rate. there was more significant increase in the means of PEFR (liter/min) for all subgroups of mild intermittent, mild persistent, moderate persistent and severe persistent of the patients age (5-13) years on 15 min after receiving nebulized salbutamol with magnesium sulfate than those receiving nebulized salbutamol alone. On receiving salbutamol alone the mild intermittent, mild persistent, moderate persistent and severe persistent subgroups improved by 51.8%, 54.9%, 49.7% and 53.5% respectively. The protective effects of inhaled magnesium sulfate on exercise induced asthma in children and he found that the combination gave better protective compared to salbutamol alone. Magnesium sulfate aerosol alone did not induce bronchial dilatation it diminished both hypersensitivity and hyper reactivity of the bronchial tree to acetylcholine induced increment of histamine in the exhaled air condensate. This data allow bronchial smooth muscles and mast cell to be regarded as target for magnesium sulfate