Farshadfar Kimia, Sohooli Maryam, Shekouhi Ramin, Taherinya Ali, Qorbani Mostafa, Rezaei-Kojani Mehdi
Alborz University of Medical Sciences, Karaj, Iran.
Colorectal Research Center, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
Asthma Res Pract. 2021 Nov 30;7(1):15. doi: 10.1186/s40733-021-00081-1.
Asthma exacerbation is defined as an acute attack of shortness of breath with more than 25% decrease in morning peak flow compared to the baseline on 2 consecutive days, which requires immediate standard therapy. The majority of asthmatic patients are considered to be steroid-sensitive; however, corticosteroid-resistant asthma is a subset of asthma with poor response to corticosteroids and is responsible for frequent hospital admissions. In this study we aimed to compare the effects of two enhancing strategies, the nebulized ketamine and IV magnesium sulfate, in treatment of severe steroid resistant asthma.
This double-blind randomized clinical trial was conducted on patients who presented to a referral clinic in Alborz, Iran. Using random allocation, patients were divided into two groups. The first group was treated with nebulized ketamine and the second group was treated with intravenous magnesium sulfate. Peak expiratory flow rates were assessed before the intervention, 30 and 60 min after the intervention and compared with the aid of SPSS software.
The Peak expiratory flow rates before the intervention, 30 min and 60 min after the intervention was statistically significantly different in both ketamine and magnesium sulfate groups. Peak expiratory flow rates change between 0 and 60 min were 29.4 and 15.2% in the ketamine and magnesium sulfate group respectively. Although the ketamine group showed much higher increase in mean PEFR compared to the MgSO groups, there was no statistically significant difference across both groups.
Our study concluded that combined with standard therapy, both ketamine and IV magnesium sulfate are effective agents in the improvement of PEFR in patients with acute severe asthma that failed to respond to traditional therapies. However, there were no statistically significant difference between the two groups.
哮喘急性发作被定义为连续两天早晨呼气峰流速较基线水平下降超过25%的急性呼吸急促发作，这需要立即进行标准治疗。大多数哮喘患者被认为对类固醇敏感；然而，糖皮质激素抵抗性哮喘是哮喘的一个亚组，对糖皮质激素反应不佳，且是导致频繁住院的原因。在本研究中，我们旨在比较两种强化策略，即雾化氯胺酮和静脉注射硫酸镁，在治疗重度糖皮质激素抵抗性哮喘中的效果。
这项双盲随机临床试验在伊朗阿尔伯兹一家转诊诊所就诊的患者中进行。通过随机分配，患者被分为两组。第一组接受雾化氯胺酮治疗，第二组接受静脉注射硫酸镁治疗。在干预前、干预后30分钟和60分钟评估呼气峰流速，并借助SPSS软件进行比较。
氯胺酮组和硫酸镁组在干预前、干预后30分钟和60分钟的呼气峰流速在统计学上有显著差异。氯胺酮组和硫酸镁组在0至60分钟之间呼气峰流速的变化分别为29.4%和15.2%。尽管氯胺酮组的平均呼气峰流速增加幅度明显高于硫酸镁组，但两组之间在统计学上没有显著差异。
我们的研究得出结论，与标准治疗相结合，氯胺酮和静脉注射硫酸镁都是改善对传统治疗无反应的急性重度哮喘患者呼气峰流速的有效药物。然而，两组之间在统计学上没有显著差异。
