Magnesium sulphate in acute exacerbations of chronic obstructive pulmonary disease: benefit not yet fully demonstrated

Magnesium sulphate in acute exacerbations of chronic obstructive pulmonary disease: benefit not yet fully demonstrated

SOURCE

Ni H, Aye SZ, Naing C.
Magnesium sulfate for acute exacerbations of chronic obstructive pulmonary disease.
Cochrane Database of Systematic Reviews 2022, Issue 5. Art. No.: CD013506.
DOI: 10.1002/14651858.CD013506.pub2

CLINICAL QUESTION

What are the effects of intravenous (IV) or inhaled magnesium sulphate (MgSO4) in adult patients with chronic obstructive pulmonary disease (COPD) exacerbations?

BOTTOM LINE

Compared with placebo, the administration of MgSO4 by the IV route may reduce the number of hospitalisations via the emergency department (low level of evidence) as well as the length of hospitalization stay (low level of evidence). The use of inhaled MgSO4 may reduce the length of hospitalization stay (very low level of evidence) without reducing their number (very low level of evidence). Whatever the route of administration, MgSO4 seems not altering the need for ventilatory support (very low level of evidence).

IV or inhaled MgSO4 compared with inhaled ipratropium bromide seems not altering the number of hospital admissions, the use of ventilatory support or the length of hospital stay (very low level of evidence). There was not enough evidence to say that magnesium inhalation was not associated with important harms such as all-cause mortality, adverse events or serious adverse events.

CAVEATS

Given the limited number of patients and the considerable heterogeneity between studies, the benefit of MgSO4 in COPD exacerbations remains to be demonstrated.

AUTHORS

Nordine Nekhili
nordine.nekhili@gmail.com
SMUR, centre hospitalier de Gonesse, F-95500 Gonesse, France

Nicolas Cazes
nicolas.cazes@icloud.com
Hôpital d’Instruction des armées Laveran, F-13013 Marseille, France