title: Intravenous magnesium sulphate as an adjuvant therapy in acute exacerbations of chronic obstructive pulmonary disease: a single centre, randomised, double-blinded, parallel group, placebo-controlled trial: a pilot study.
abstract: OBJECTIVE
  To investigate the effects on lung function of IV magnesium in acute exacerbations of COPD (AECOPD), when given in conjunction with standard bronchodilator therapy.
  
  
  METHODS
  This was a pilot study to a randomised, double-blinded, placebo-controlled trial. 30 patients presenting to ED with AECOPD were included. In addition to standard bronchodilator therapy, 17 patients were given saline, and 13 received 2 g of magnesium sulphate intravenously. Spirometry was carried out at presentation (TA), after initial standard bronchodilator therapy (TB) and immediately (T0), at 60 minutes (T60) and 120 minutes (T120) after trial drug infusion. Primary outcomes were percentage change in FEV1 and FVC at T0, T60 and T120. Secondary outcomes were admission rates, length of stay and requirement for NIV or mechanical ventilation. Trial registration (ANZCTR), ACTRN12613000837729.
  
  
  RESULTS
  Greater improvements were seen in FEV1 at T0, T60 and T120 compared to TB in magnesium group (at T120, mean percentage change in FEV1 was 27.07% with magnesium versus 11.39% in the placebo group, 95%CI 3.7 to 27.7, p=0.01). Similar significantly greater improvements were noted with FVC in the magnesium group, compared to TB.
  
  
  CONCLUSIONS
  IV magnesium sulphate used as an adjunct therapy to standard bronchodilators in AECOPD presenting to ED may improve lung function in the short term.
authors.affiliation: Emergency Department, Hutt Valley DHB, Pilmuir House, Hutt Hospital Campus, Lower Hutt, New Zealand 5010. sapimukerji@doctors.org.uk.
authors.forename: Saptarshi
authors.initials: S
authors.lastname: Mukerji
authors.forename: Berinder
authors.initials: B
authors.lastname: Shahpuri
authors.forename: Bevan
authors.initials: B
authors.lastname: Clayton-Smith
authors.forename: Nicola
authors.initials: N
authors.lastname: Smith
authors.forename: Patrick
authors.initials: P
authors.lastname: Armstrong
authors.forename: Moira
authors.initials: M
authors.lastname: Hardy
authors.forename: George
authors.initials: G
authors.lastname: Marchant
authors.forename: Emma
authors.initials: E
authors.lastname: Marsh
mesh_terms: D000280:Administration, Inhalation; D061605:Administration, Intravenous; D000368:Aged; D000369:Aged, 80 and over; D000420:Albuterol / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D018450:Disease Progression; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005541:Forced Expiratory Volume; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D009241:Ipratropium / Q000627:therapeutic use; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D010865:Pilot Projects; D011241:Prednisone / Q000627:therapeutic use; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000628:therapy*; D014797:Vital Capacity
chemical_list: D001993:Bronchodilator Agents; D005938:Glucocorticoids; D008278:Magnesium Sulfate; D009241:Ipratropium; D000420:Albuterol; D011241:Prednisone; D006854:Hydrocortisone