Abstract:
The purpose of this meta-analysis was to evaluate the efficacy of nebulised magnesium in the treatment of acute exacerbation of COPD. PubMed and Embase databases were searched for randomised controlled trials comparing any dose of nebulised magnesium sulphate with placebo for treatment of acute exacerbation of COPD, published from database inception till 30 June 2022. Bibliographic mining of relevant results was performed to identify any additional studies. Data extraction and analyses were done independently by review authors and any disagreements were resolved through consensus. Meta-analysis was done using a fixed-effect model at clinically significant congruent time points reported across maximum studies to ensure comparability of treatment effect. Four studies met the inclusion criteria, randomly assigning 433 patients to the comparisons of interest in this review. Pooled analysis showed that nebulised magnesium sulphate improved pulmonary expiratory flow function at 60 minutes after initiation of intervention compared to placebo [median difference (MD) 9.17%, 95% confidence interval (CI) 2.94 to 15.41]. Analysis of expiratory function in terms of standardised mean differences (SMD) revealed a small yet significant positive effect size (SMD 0.24, 95% CI 0.04 to 0.43). Among the secondary outcomes, nebulised magnesium sulphate reduced the need for ICU admission (risk ratio 0.52, 95% CI 0.28 to 0.95), amounting to 61 fewer ICU admissions per 1000 patients. No difference was noted in the need for hospital admission, need for ventilatory support, or mortality. No adverse events were reported. Nebulised magnesium sulphate improves pulmonary expiratory flow function and reduces the need for ICU admission in patients with acute exacerbation of COPD.
摘要:
这项荟萃分析的目的是评估雾化镁治疗COPD急性加重的疗效。在PubMed和Embase数据库中搜索随机对照试验,比较任何剂量的雾化硫酸镁与安慰剂治疗COPD急性加重的疗效。从数据库开始到2022年6月30日发布。进行相关结果的书目挖掘以确定任何其他研究。数据提取和分析由综述作者独立完成,任何分歧通过共识解决。使用固定效应模型在最大研究报告的临床显著一致时间点进行荟萃分析,以确保治疗效果的可比性。四项研究符合纳入标准,在本综述中,随机分配433例患者参加感兴趣的比较.汇总分析显示,与安慰剂相比,雾化硫酸镁在开始干预后60分钟改善了肺呼气流量功能[中位数差异(MD)9.17%,95%置信区间(CI)2.94至15.41]。根据标准化平均差异(SMD)对呼气功能进行的分析显示出很小但显着的正效应大小(SMD0.24,95%CI0.04至0.43)。在次要结果中,雾化硫酸镁减少了ICU入住的需要(风险比0.52,95%CI0.28至0.95),每1000名患者中ICU入院人数减少61人。入院的需要没有差异,需要通气支持,或死亡率。未报告不良事件。雾化硫酸镁可改善COPD急性加重患者的肺呼气流量功能,并减少ICU入住需求。