Comparison of nebulized magnesium sulfate plus albuterol to nebulized albuterol plus saline in children with acute exacerbations of mild to moderate asthma

Effectiveness of Inhaled MgSO4 as an Adjuvant to Initial Treatment of Acute Moderate Asthma in Children: An open Randomized Controlled Trial

“…However, the greatest clinical response was seen in children with more severe attacks (SaO2<92%) at presentation and those with preceding symptoms lasting less than 6 h. Our study did show significant improvement in PRAM score in the magnesium group as compared to normal saline group at every point of evaluation in children with moderate asthma. There are studies done by Mahajan et al 14 and Hughes R J 15 which show improved pulmonary function in the early 20 minutes in the magnesium group in children with severe asthma. In Cochrane systemic review, Blitz M et al 16 showed that Nebulized inhaled magnesium sulfate in addition to β2-agonist in the treatment of an acute asthma exacerbation, appears to have benefits with respect to improved pulmonary function in patients with severe asthma and there is a trend towards benefit in hospital admission.…”

Aerosolized Surfactants, Anti-Inflammatory Drugs, and Analgesics

“…70 Studies with intravenous magnesium have generally not shown benefit in adult asthma 71,72 but have shown a minimal but significant effect on lung function (generally FEV 1 or peak expiratory flow) in pediatric asthma. 73,74 In the multi-center pediatric MAGNETIC study, inhaled magnesium compared with saline (added to albuterol and ipratropium) resulted in a statistically significant improvement in asthma severity score at 60 min. This did not, however, result in a difference in any longerterm outcome (stay, intubation, or pediatric ICU admission).…”

“…There is, however, little evidence of prolonged bronchodilation or any improvement in ultimate outcomes in acute asthma. Given the suggestion that it may be effective in more severe asthmatic cases, 74 inhaled or intravenous magnesium is frequently added when the standard nebulized ␤ 2 agonists plus ipratropium do not completely resolve clinical symptoms.…”

Unlabeled uses of nebulized medications

“…The search for treatment alternatives for bronchoconstriction in acute asthma has led to the use of nebulized magnesium sulfate. 31 Magnesium has been associated with cellular homeostasis and frequently acts as a cofactor in enzymatic reactions. It has also been suggested that magnesium acts as a smooth muscle relaxant by interfering with calcium uptake.…”