Clinical Question

Is magnesium sulfate an effective addition to usual care for adults with chronic obstructive pulmonary disease (COPD) exacerbations?

Evidence-Based Answer

Adding intravenous magnesium to standard care for adults with COPD exacerbations may decrease hospital admissions and the length of hospitalization. Seven people with COPD exacerbations would need to be treated with intravenous magnesium to prevent one admission. Patients treated with intravenous magnesium who require hospitalization have a decreased length of stay (mean difference = 2.7 days). There is insufficient evidence about the frequency and severity of adverse events.¹ (Strength of Recommendation: A, consistent, good-quality patient-oriented evidence.)

Practice Pointers

Acute exacerbations of COPD are common, with 7% to 33% of patients being hospitalized for severe exacerbations per year, depending on their baseline severity of illness.² The authors of the Cochrane review sought to determine the effectiveness and safety of nebulized and intravenous magnesium sulfate in treating COPD exacerbations in terms of hospitalization rate and other factors.