Chronic Obstructive Pulmonary Disease (COPD) is a persistent respiratory condition that may cause progressive lung damage over time. A significant aspect of this disease is the occurrence of acute exacerbations, which are episodes where a person’s respiratory symptoms significantly worsen. These exacerbations can contribute to the progression of COPD, increase healthcare costs, lead to changes in treatment plans and medication, cause irreversible lung damage, lower the quality of life, and increase the risk of hospitalization and death.
Exacerbations are often triggered by factors such as viral infections, bacterial tracheobronchial infections, smoking, air pollutants, irritants like chemical agents, fumes, dust, and chronic bronchitis. The most common symptom of an exacerbation is dyspnea, which is shortness of breath or difficulty breathing. Other symptoms may include increased coughing, feeling excessively sleepy or confused, lower oxygen levels than expected, increased sputum production, wheezing, and chest tightness.
Recognizing the early signs of a COPD exacerbation is crucial as one exacerbation may be enough to increase the frequency, duration, and severity of future episodes. Therefore, it’s important to consult with a healthcare professional if you experience any of these symptoms. The average person with COPD experiences between 0.85–1.3 exacerbations a year, and these episodes may last between 7 and 14 days. However, lung function may not fully return to pre-exacerbation levels even after 8 weeks.
Magnesium has a bronchodilatory effect and this Cochrane Review evaluated this effect in COPD flare:
- Intravenous Magnesium Sulfate:
- Associated with fewer hospital admissions.
- Reduced length of hospital stay.
- Improved dyspnoea scores compared to placebo.
- No evidence of a difference in NIV, lung function, oxygen saturation, or adverse events.
- No evidence for ICU admission, endotracheal intubation, serious adverse events, or mortality.
- Nebulised Magnesium Sulfate:
- Uncertain effects for most outcomes in COPD exacerbations.
- Some studies suggest possibly lower ICU admissions and reduced dyspnoea with magnesium inhalation compared to placebo.
- However, larger studies are needed for more precise estimates.
- No robust evidence for magnesium sulfate compared to ipratropium bromide.
Resources:
Ni H, Aye SZ, Naing C. Magnesium sulfate for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews 2022, Issue 5. Art. No.: CD013506. DOI: 10.1002/14651858.CD013506.pub2. Accessed 28 February 2024.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013506.pub2/full
https://www.healthline.com/health/copd/exacerbation-symptoms-and-warning-signs
