Clinical Efficacy of Nebulized Magnesium Sulfate in Acute Exacerbations of COPD and Bronchial Asthma: Impact on Early Recovery and ICU Admission

Open Access

Abstract

Background: Acute exacerbations of (COPD) and bronchial asthma are major causes of hospital admission and are associated with significant morbidity and healthcare burden. Nebulized magnesium sulfate has been proposed as an adjunctive bronchodilator to improve clinical outcomes during acute exacerbations. Methods & Materials: This prospective comparative observational study was conducted in the Department of Medicine, Monno Medical College & Hospital, Manikganj, Bangladesh, from January to December 2025. A total of 250 hospitalized patients, including 125 with acute bronchial asthma and 125 with acute exacerbation of COPD, were enrolled by consecutive sampling. All patients received standard treatment with adjunctive nebulized magnesium sulfate. Clinical characteristics, pulmonary function, oxygen saturation, early clinical recovery, ICU admission, hospital stay, and adverse events were evaluated. Data were analyzed using SPSS version 25.0, and a p-value <0.05 was considered statistically significant. Results: Asthma patients showed significantly greater improvement in respiratory distress, wheezing, oxygen saturation, and PEFR than COPD patients (all p<0.05). Mean recovery time was significantly shorter in asthma patients (27.8±10.4 vs. 36.2±12.8 hours; p<0.001). ICU admission (7.2% vs. 19.2%), mechanical ventilation (4.0% vs. 11.2%), and mean hospital stay (3.5±1.3 vs. 4.9±2.0 days) were significantly lower in the asthma group. Nebulized magnesium sulfate was well tolerated, with only minimal adverse effects. Conclusion: Nebulized magnesium sulfate is a safe and effective adjunct to standard therapy, improving early clinical recovery and short-term outcomes in acute exacerbations of COPD and bronchial asthma.