Value of Adding Nebulized Magnesium Sulphate to Rescue Medications in Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Patients Admitted to Emergency Room

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases. COPD exacerbations play a central role in the natural history of the disease, affecting its overall severity, decreasing pulmonary function, worsening underlying co-morbidities, impairing quality of life and leading to severe morbidity and mortality. Besides COPD severity, the history of exacerbations is also a good predictor of future exacerbations. Furthermore, there is a strong correlation with symptoms of depression and recurrent exacerbations Several studies have identified clinical and conventional laboratory parameters associated with higher rates of readmission following an AECOPD. These variables include age, sex, physical capacity, levels of partial arterial oxygen pressure and partial arterial carbon dioxide pressure, global and respiratory muscle weakness, socioeconomic status, health-related quality of life and anxiety or depression, cured meat consumption and adherence to inhaled therapy and follow-up. In the airways, magnesium is a bronchodilator through various mechanisms including an inhibitory effect on bronchial smooth muscle contraction mediated by calcium and an inhibitory effect on acetylcholine release from cholinergic nerve terminals and histamine from mas