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Am Fam Physician. 2022;106(5):online

Author disclosure: No relevant financial relationships.

Details for This Review

Study Population: Adults 35 years and older in seven countries presenting to an emergency department (ED) with an acute exacerbation of chronic obstructive pulmonary disease (COPD)

Efficacy End Points: Hospital admissions from the ED and the need for noninvasive ventilation, assisted ventilation, or intensive care unit admission

Harm End Points: Adverse events or serious adverse events

Narrative: COPD is a chronic, progressive disease often complicated by exacerbations that commonly lead to hospital admissions, decreased quality of life, and increased morbidity and mortality. Novel strategies have been suggested to decrease the rate of hospitalizations for acute COPD exacerbations.

Some evidence suggests that hypomagnesemia increases airway hyperreactivity, impairs pulmonary function, and increases the risk of COPD exacerbations.1,2 A 2008 study showed that hypomagnesemia is an independent predictor of readmission to the hospital for acute COPD exacerbations.3 Magnesium sulfate infusions are used as adjuvant therapy for asthma exacerbations because of their bronchodilatory effect.4 Similarly, magnesium sulfate may have potential as adjuvant therapy for COPD exacerbations.

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This series is coordinated by Christopher W. Bunt, MD, AFP assistant medical editor, and the NNT Group.

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