Asthma Exacerbation, Emergency Department, High Dose, Magnesuim Sulfate
Conditions
Keywords
asthma exacerbation, magnesium sulfate, emergency department
Brief summary
The goal of this clinical is to compare treatment outcomes between high dose continuous IV Magnesium and standard therapy in the management of acute exacerbation of asthma in the emergency department. Participants will random assign to either high dose continuous IV drip or standard infusion. Participants in the intervention group received high-dose 50% magnesium sulfate (MgSO4), consisting of 2 g + normal saline (NSS) 100 ml administered intravenously over 30 minutes, followed by MgSO4 6 g + NSS 350 ml infused over 3.5 hours (approximately 40-50 mg/kg/h). In contrast, participants in the control group received standard-dose 50% MgSO4, consisting of 2 g + NSS 100 ml administered intravenously over 30 minutes, followed by a NSS 350 ml infusion over 3.5 hours. Measurements include symptom severity, respiratory rate, oxygen saturation, and pulmonary function tests. Primary endpoints are ED stay length, hospital admission, and ED revisit within 48 hours post-discharge. Adverse events are documented.
Interventions
DRUG้High-dose Magnesium sulphate
Participants in the intervention group received high-dose 50% magnesium sulfate (MgSO₄), consisting of 2 g diluted in 100 mL normal saline (NSS) administered intravenously over 30 minutes, followed by MgSO₄ 6 g diluted with NSS up to a total volume of 350 mL infused intravenously over 3.5 hours (approximately 40-50 mg/kg/h).
DRUGstandard-dose Magnesium Sulfate
Participants in the control group received standard-dose 50% MgSO₄, consisting of 2 g diluted in 100 mL NSS administered intravenously over 30 minutes, followed by 350 mL NSS infused over 3.5 hours
Sponsors
Thammasat University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Intervention model description
randomized controlled trial - RCT
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Adults aged ≥18 years with a known diagnosis of asthma, and * Presence of signs and symptoms consistent with acute asthma exacerbation, including dyspnea, tachypnea, respiratory distress, chest tightness, cough, or wheezing, and * Indication for administration of intravenous magnesium sulfate (MgSO4)
Exclusion criteria
* Patients requiring endotracheal intubation at the time of initial presentation * Hypermagnesemia (more than 2.5 mg/dL) * Known hypersensitivity to magnesium sulfate * Diagnosed or suspected myasthenia gravis or neuromuscular disease * Suspected infection meeting the criteria for patients under investigation (PUI) for coronavirus disease 2019 (COVID-19) * Suspected or confirmed pulmonary tuberculosis * inability to perform pulmonary function testing (spirometry or peak expiratory flow) * known case chronic kidney disease (eGFR \<30 mL/min/1.73 m²), heart block, pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Length of ED stay (hours) | through study completion, an average of 1 year | Length of ED stay was defined as the time from administration of the first nebulized treatment to the time of physician-ordered disposition from the emergency department. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hospital admission rate (%) | through study completion, an average of 1 year | Hospital admission rate (%) was defined as admission to an inpatient ward or intensive care unit directly from emergency department following the index visit. |
Contacts
CONTACTKumpol Kornthatchapong, Associated Professor, MD.Ph.D.
CONTACTDepartment of Emergency Medicine Faculty of Medicine
Outcome results
None listed