Effect of Inhaled MgSO4 on FEV1 and PEF in Children with Asthma Induced by Acetylcholine: A Randomized Controlled Clinical Trail of 330 Cases

Sun, Yung-Chen; Gong, Caihui; Liu, S.; Yuan, Xiu; Yin, Lijuan; Yan, Lan; Shi, Tong; Dai, Jihong

doi:10.1093/tropej/fmt099

Cited by 10 publications

(2 citation statements)

References 13 publications

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“…Although side effects had happened with both groups as palpitation (22%) and tremors (15%) were higher in nebulized salbutamol treated group, and nausea (6%), taste changes (6%), numbness (7%) and dizziness (7%) were higher in nebulized MgSO4 treated group, accordingly both drugs are well tolerated by the patients. In agreement with our results, Sun et al [15] , concluded that nebulized MgSO 4 , used alone, had a bronchodilator effect in acetylcholine induced asthma in children. Kew et al [16] , concluded that inhaled magnesium consequential in improvement of severe asthma attacks, but highlight that limited improvement could be related to severe airway obstruction.…”

Section: Discussionsupporting

confidence: 94%

Magnesium Sulphate (MgSO4) Nebulization versus Salbutamol Nebulization in Acute Asthmatic Attacks in Adults

Elrifai

Elsayad

Hussein

2020

Journal of Recent Advances in Medicine

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Background: Short acting ß2-agonist is considered the main stay of therapy in acute asthma episodes, but it could not completely relieve the bronchospasm and reduce dyspnea. One of the other treatments is magnesium sulphate (MgSO4). Nebulized MgSO4 effect has been less evaluated in asthmatics. Aim of the Work: To compare the effects of nebulized MgSO4 in higher doses versus salbutamol nebulization in severe asthmatic attacks in adults. Patients and Methods: Two hundreds asthmatic patients with acute severe attacks were included in an interventional study. Following initial clinical evaluation and spirometric measurements; peak expiratory flow (PEF) and forced expiratory volume in the first second (FEV1%) measurements, patients were divided into two equal groups; group I: nebulized salbutamol and group II: nebulized MgSO4. Salbutamol group received salbutamol (2.5 ml) + isotonic saline (2.5 ml) while MgSO4 group received MgSO4 (500mg), 7.5 ml (2 mmol vial), through a jet nebulizer. The nebulization was given three times for the first two hours, 20 minutes apart, and then every hour for the remaining four hours. After that clinical reevaluation, PEF and FEV1% measurements were done. Results: The pre-nebulizer clinical parameters, PEF and FEV1 were nearly similar between groups I and II:

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Section: Discussionsupporting

confidence: 94%

Magnesium Sulphate (MgSO4) Nebulization versus Salbutamol Nebulization in Acute Asthmatic Attacks in Adults

Elrifai

Elsayad

Hussein

2020

Journal of Recent Advances in Medicine

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“…A recent RCT evaluated the effect of nebulized MgSO4, on FEV1 and PEF in children with asthma induced by acetylcholine [ 60 ]. The nebulized MgSO4 showed a wide bronchodilator effect but the rise in FEV1 and PEF was not superior to salbutamol.…”

Section: Resultsmentioning

confidence: 99%

Guideline on management of the acute asthma attack in children by Italian Society of Pediatrics

2018

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BackgroundAcute asthma attack is a frequent condition in children. It is one of the most common reasons for emergency department (ED) visit and hospitalization. Appropriate care is fundamental, considering both the high prevalence of asthma in children, and its life-threatening risks.Italian Society of Pediatrics recently issued a guideline on the management of acute asthma attack in children over age 2, in ambulatory and emergency department settings.MethodsThe Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was adopted. A literature search was performed using the Cochrane Library and Medline/PubMed databases, retrieving studies in English or Italian and including children over age 2 year.ResultsInhaled ß2 agonists are the first line drugs for acute asthma attack in children. Ipratropium bromide should be added in moderate/severe attacks. Early use of systemic steroids is associated with reduced risk of ED visits and hospitalization. High doses of inhaled steroids should not replace systemic steroids. Aminophylline use should be avoided in mild/moderate attacks. Weak evidence supports its use in life-threatening attacks. Epinephrine should not be used in the treatment of acute asthma for its lower cost / benefit ratio, compared to β2 agonists. Intravenous magnesium solphate could be used in children with severe attacks and/or forced expiratory volume1 (FEV1) lower than 60% predicted, unresponsive to initial inhaled therapy. Heliox could be administered in life-threatening attacks. Leukotriene receptor antagonists are not recommended.ConclusionsThis Guideline is expected to be a useful resource in managing acute asthma attacks in children over age 2.

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Inhaled magnesium sulfate in the treatment of acute asthma

Powell

Dwan

Milan

et al. 2017

Cochrane Database of Systematic Reviews

102

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Treatment with nebulised MgSO₄ may result in modest additional benefits for lung function and hospital admission when added to inhaled β₂-agonists and ipratropium bromide, but our confidence in the evidence is low and there remains substantial uncertainty. The recent large, well-designed trials have generally not demonstrated clinically important benefits. Nebulised MgSO₄ does not appear to be associated with an increase in serious adverse events. Individual studies suggest that those with more severe attacks and attacks of shorter duration may experience a greater benefit but further research into subgroups is warranted.Despite including 24 trials in this review update we were unable to pool data for all outcomes of interest and this has limited the strength of the conclusions reached. A core outcomes set for studies in acute asthma is needed. This is particularly important in paediatric studies where measuring lung function at the time of an exacerbation may not be possible. Placebo-controlled trials in patients not responding to standard maximal treatment, including inhaled β₂-agonists and ipratropium bromide and systemic steroids, may help establish if nebulised MgSO₄ has a role in acute asthma. However, the accumulating evidence suggests that a substantial benefit may be unlikely.

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Effect of Inhaled MgSO4 on FEV1 and PEF in Children with Asthma Induced by Acetylcholine: A Randomized Controlled Clinical Trail of 330 Cases

Abstract: Nebulized magnesium sulfate alone has a bronchodilatory effect in Ach-induced asthmatic children. The combination of MgSO4 and albuterol did not has a synergistic effect.

Cited by 10 publications

References 13 publications

Magnesium Sulphate (MgSO4) Nebulization versus Salbutamol Nebulization in Acute Asthmatic Attacks in Adults

Magnesium Sulphate (MgSO4) Nebulization versus Salbutamol Nebulization in Acute Asthmatic Attacks in Adults

Guideline on management of the acute asthma attack in children by Italian Society of Pediatrics

Inhaled magnesium sulfate in the treatment of acute asthma

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