College of Medicine - Master of Physician Assistant Studies Capstone Projects

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Browsing College of Medicine - Master of Physician Assistant Studies Capstone Projects by Subject "asthma"

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    DOES INTRAVENOUS MAGNESIUM REDUCE HOSPITAL ADMISSION RATES IN ADULTS WITH SEVERE ACUTE ASTHMA?
    (2015-04) Hall, Steven
    Introduction: Asthma is a chronic respiratory disease characterized by bronchial hyper-responsiveness, airflow obstruction, and inflammation that presents with symptoms of cough, dyspnea, chest tightness, wheezing, and sputum production. Symptoms of asthma can range from mild to severe, resulting in hospitalization, intubation, and even death. In addition to inhaled beta agonists, nebulized ipratropium, oxygen, and systemic corticosteroids, magnesium sulfate has been used as an adjunctive treatment of acute severe asthma exacerbations. However, despite its use, its effectiveness has been inconclusive and controversial, with previous studies showing the greatest benefit in those having severe exacerbations. This literature review was conducted to determine if magnesium sulfate administration reduces hospital admission rates in adults with acute, severe exacerbations. Methods: A literature search was conducted for research studies of adult patients who presented with an acute, severe asthma exacerbation and were treated with intravenous magnesium sulfate. Study dates were limited to the years 1989-2014, and were identified through PubMed, Scopus, Embase, and Google Scholar, with further studies identified through the search of reference lists of published articles. A total of 11 studies were found using the sources above. Of these 11 studies, 5 double blind, randomized, placebo controlled trials were selected for this review. Results: Results from the five randomized controlled trials selected were mixed, with two studies showing a decrease in admissions (one had weak evidence of a decrease), and three studies showing no difference in admission rates. Conclusion: Intravenous magnesium sulfate does not appear to decrease admission rates in adult asthmatics having a severe exacerbation.