Status asthmaticus and the use of ketamine nebulization and magnesium sulfate: current strategies and outcomes.

This narrative review aims to systematically explore and synthesize the current literature on the efficacy and safety of ketamine nebulization and magnesium sulfate as therapeutic interventions in the management of status asthmaticus. The review evaluates clinical outcomes, administration protocols, and potential adverse effects associated with these treatments. Ketamine has proven effective in managing asthma due to its bronchodilator properties, primarily by stimulating nitric oxide and catecholamine release. Magnesium sulfate has shown benefits by interfering with calcium influx, which alleviates bronchospasm and enhances bronchodilation. Both treatments have been associated with improvements in FEV1 and peak expiratory flow rates, which improve blood oxygenation and reduce bronchospasm. Despite the promising results, more research is needed to determine the optimal dosages and administration routes for these interventions. Furthermore, current studies often do not use these treatments as first-line options, which may introduce confounding variables. Future research should focus on establishing clear protocols for the use of ketamine and magnesium sulfate in refractory acute-severe asthma and status asthmaticus. This review highlights the potential for these treatments to improve clinical outcomes when standard corticosteroid therapies are insufficient, suggesting that with appropriate dosing and consideration, they could be valuable additions to the management strategies for severe asthma exacerbations.