Nebulized Magnesium Sulfate as an Adjunct to Standard Therapy in Asthma Exacerbation
Nebulized Magnesium Sulfate as an Adjunct to Standard Therapy in Asthma Exacerbation
The purpose of this study is to investigate the effectiveness of nebulized magnesium sulfate
 in patient with moderate to severe asthma exacerbation in pediatric emergency
The inclusion period of the patients in this research will be on September 2015 to November
 2015. Patients are going to be selected by the medical staff on duty in the emergency
 paediatric service, according to the criteria previously established inclusion and exclusion.
 Immediately a baseline degree of respiratory distress using PRAM scale and heart rate,
 respiratory rate, blood pressure and oxygen saturation. While informed consent in which the
 objective and characteristics of the study will be obtained will be explained.

 Patients will be randomly assigned one of the two treatments in the Research: standard
 treatment for moderate to severe asthma attack, according to GINA or standard treatment plus
 nebulised magnesium sulphate, according to the table of random allocation of treatment.

 Evaluations were performed after administration of each spray, that is, at 20, 40, 60, 120,
 180 and 240 minutes after beginning treatment. The parameters' to evaluate are going to be
 heart rate, respiratory rate, oxygen saturation, blood pressure and assessment of severity of
 acute asthma with PRAM scale.

 The application of nebulized drugs are made in the emergency department of pediatrics by
 inhalation therapy staff who are also responsible for the preparation of medicines. It is
 clear that this staff not participate in the evaluation of patients, which will be performed
 by the research staff or by medical staff on duty in the pediatric emergency department.

 Patients and evaluating physician will not pick out between the two solutions for
 nebulization not only colour but also smell or other special feature, because the solutions
 were arranged in two identical syringes. Administered alone at the end of the study treatment
 is known.

 Later the entry or exit of the patient decide, who can be egress to show clinical improvement
 with decreased severity index PRAM, patients will be graduates of an outpatient treatment
 according to international guidelines on the management of acute asthma. All initial and
 outcome data will be recorded in a format of data collection All decisions will be made by
 patients pediatricians emergency department which will follow patients throughout the study
 and will have the power to release the study patients to use other interventions that they
 consider clinically necessary
Inclusion Criteria:

 -  Clinical diagnosis of moderate or severe asthma exacerbations

 -  2 to 15 years old.

 -  Served in the pediatric emergency department of naval high specialty General Hospital
 from September to December 2015.

 -  Signing the consent by the parents.

 Exclusion Criteria:

 -  Coexistence of lung disease.

 -  Severe kidney disease.

 -  Severe liver disease.

 -  Pregnancy.

 -  Known previous reaction to magnesium.

 -  Parents who have not signed the agreement.

 -  Patients without a clinical history of asthma.

 -  Clinical diagnosis of mild asthma attack.

 -  Previously included in the study.

 -  Presence of comorbidities that endanger the patient's life.

 -  The patient has clinical or gasometric criteria for advanced airway management.

 -  Life-threatening symptoms.