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

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 st...

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Autores principales: Kimia Farshadfar, Maryam Sohooli, Ramin Shekouhi, Ali Taherinya, Mostafa Qorbani, Mehdi Rezaei-kojani
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Publicado: BMC 2021
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spelling oai:doaj.org-article:9d1e0c136f5e412cac405b9bd1dec72b2021-12-05T12:24:40ZThe effects of nebulized ketamine and intravenous magnesium sulfate on corticosteroid resistant asthma exacerbation; a randomized clinical trial10.1186/s40733-021-00081-12054-7064https://doaj.org/article/9d1e0c136f5e412cac405b9bd1dec72b2021-11-01T00:00:00Zhttps://doi.org/10.1186/s40733-021-00081-1https://doaj.org/toc/2054-7064Abstract 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.Kimia FarshadfarMaryam SohooliRamin ShekouhiAli TaherinyaMostafa QorbaniMehdi Rezaei-kojaniBMCarticleAsthmaKetaminePeak expiratory flow rateMagnesium sulfateDiseases of the respiratory systemRC705-779ENAsthma Research and Practice, Vol 7, Iss 1, Pp 1-7 (2021)
institution DOAJ
collection DOAJ
language EN
topic Asthma
Ketamine
Peak expiratory flow rate
Magnesium sulfate
Diseases of the respiratory system
RC705-779
spellingShingle Asthma
Ketamine
Peak expiratory flow rate
Magnesium sulfate
Diseases of the respiratory system
RC705-779
Kimia Farshadfar
Maryam Sohooli
Ramin Shekouhi
Ali Taherinya
Mostafa Qorbani
Mehdi Rezaei-kojani
The effects of nebulized ketamine and intravenous magnesium sulfate on corticosteroid resistant asthma exacerbation; a randomized clinical trial
description 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.
format article
author Kimia Farshadfar
Maryam Sohooli
Ramin Shekouhi
Ali Taherinya
Mostafa Qorbani
Mehdi Rezaei-kojani
author_facet Kimia Farshadfar
Maryam Sohooli
Ramin Shekouhi
Ali Taherinya
Mostafa Qorbani
Mehdi Rezaei-kojani
author_sort Kimia Farshadfar
title The effects of nebulized ketamine and intravenous magnesium sulfate on corticosteroid resistant asthma exacerbation; a randomized clinical trial
title_short The effects of nebulized ketamine and intravenous magnesium sulfate on corticosteroid resistant asthma exacerbation; a randomized clinical trial
title_full The effects of nebulized ketamine and intravenous magnesium sulfate on corticosteroid resistant asthma exacerbation; a randomized clinical trial
title_fullStr The effects of nebulized ketamine and intravenous magnesium sulfate on corticosteroid resistant asthma exacerbation; a randomized clinical trial
title_full_unstemmed The effects of nebulized ketamine and intravenous magnesium sulfate on corticosteroid resistant asthma exacerbation; a randomized clinical trial
title_sort effects of nebulized ketamine and intravenous magnesium sulfate on corticosteroid resistant asthma exacerbation; a randomized clinical trial
publisher BMC
publishDate 2021
url https://doaj.org/article/9d1e0c136f5e412cac405b9bd1dec72b
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