The effects of nebulized ketamine and intravenous magnesium sulfate on corticosteroid resistant asthma exacerbation; a randomized clinical trial.

Kimia Farshadfar, Maryam Sohooli, Ramin Shekouhi, Ali Taherinya, Mostafa Qorbani, Mehdi Rezaei-Kojani
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Abstract

Background and aims: Asthma exacerbation is defined as an acute attack of shortness of breath with more than 25% decrease in morning peak flow compared to the baseline on 2 consecutive days, which requires immediate standard therapy. The majority of asthmatic patients are considered to be steroid-sensitive; however, corticosteroid-resistant asthma is a subset of asthma with poor response to corticosteroids and is responsible for frequent hospital admissions. In this study we aimed to compare the effects of two enhancing strategies, the nebulized ketamine and IV magnesium sulfate, in treatment of severe steroid resistant asthma.

Materials and methods: This double-blind randomized clinical trial was conducted on patients who presented to a referral clinic in Alborz, Iran. Using random allocation, patients were divided into two groups. The first group was treated with nebulized ketamine and the second group was treated with intravenous magnesium sulfate. Peak expiratory flow rates were assessed before the intervention, 30 and 60 min after the intervention and compared with the aid of SPSS software.

Results: The Peak expiratory flow rates before the intervention, 30 min and 60 min after the intervention was statistically significantly different in both ketamine and magnesium sulfate groups. Peak expiratory flow rates change between 0 and 60 min were 29.4 and 15.2% in the ketamine and magnesium sulfate group respectively. Although the ketamine group showed much higher increase in mean PEFR compared to the MgSO4 groups, there was no statistically significant difference across both groups.

Conclusion: Our study concluded that combined with standard therapy, both ketamine and IV magnesium sulfate are effective agents in the improvement of PEFR in patients with acute severe asthma that failed to respond to traditional therapies. However, there were no statistically significant difference between the two groups.

Abstract Image

Abstract Image

雾化氯胺酮和静脉注射硫酸镁对皮质类固醇抵抗性哮喘加重的影响;随机临床试验。
背景和目的:哮喘加重的定义是气短的急性发作,与基线相比,晨峰流量连续两天下降超过 25%,需要立即进行标准治疗。大多数哮喘患者被认为对类固醇敏感;然而,皮质类固醇耐药哮喘是哮喘的一个分支,对皮质类固醇反应不佳,是导致频繁入院的原因。在这项研究中,我们旨在比较雾化氯胺酮和静脉注射硫酸镁这两种增强策略在治疗重度类固醇耐药哮喘中的效果:这项双盲随机临床试验的对象是在伊朗阿尔伯兹一家转诊诊所就诊的患者。通过随机分配,患者被分为两组。第一组接受氯胺酮雾化治疗,第二组接受硫酸镁静脉注射治疗。分别在干预前、干预后 30 分钟和 60 分钟评估呼气峰流速,并借助 SPSS 软件进行比较:结果:干预前、干预后 30 分钟和 60 分钟的峰值呼气流速在氯胺酮组和硫酸镁组均有显著统计学差异。氯胺酮组和硫酸镁组在 0 至 60 分钟之间的呼气峰流速变化分别为 29.4% 和 15.2%。虽然氯胺酮组的平均呼气流速增幅远高于硫酸镁组,但两组之间并无统计学差异:我们的研究得出结论,氯胺酮和静脉注射硫酸镁与标准疗法相结合,可有效改善传统疗法无效的急性重症哮喘患者的 PEFR。然而,两组之间的差异并无统计学意义。
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来源期刊
自引率
0.00%
发文量
6
审稿时长
20 weeks
期刊介绍: Asthma Research and Practice is the official publication of Interasma and publishes cutting edge basic, clinical and translational research in addition to hot topic reviews and debate articles relevant to asthma and related disorders (such as rhinitis, COPD overlapping syndrome, sinusitis). The journal has a specialized section which focusses on pediatric asthma research. Asthma Research and Practice aims to serve as an international platform for the dissemination of research of interest to pulmonologists, allergologists, primary care physicians and family doctors, ENTs and other health care providers interested in asthma, its mechanisms and comorbidities.
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