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

(4 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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“…Baseline study characteristics are reported in Table 1. In two included studies, bronchoconstriction was induced with acetylcholine provocation before randomisation to treatment with vs. without nebulised magnesium sulfate [22,23]. Post-provocation measures were considered for baseline characteristics in Table 1.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Two studies [22,23] induced bronchospasm with acetylcholine. We ran sensitivity analysis excluding those studies from the PEFR forest plot and found a similar result to our overall analysis, favoring a higher PEFR in the magnesium sulfate group (MD 5.39%; 95% CI 4.81 to 5.97%; p < 0.01; I 2 = 0%).…”

Section: Sensitivity Analysis Excluding Patients With Induced Broncho...mentioning

confidence: 99%

Standard Medical Therapy With vs. Without Nebulised Magnesium for Children with Asthma Decompensation

Cunha,

Mora,

Afzal

et al. 2024

Preprint

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Background: Pediatric asthma is a common condition, and its exacerbations can be associated with significant morbidity and mortality. The role of nebulised magnesium as adjunct therapy for children with asthma exacerbation is still unclear. Objective: To compare nebulised magnesium with standard medical therapy (SMT) vs. SMT alone for children with decompensated asthma. Methods: PubMed, Embase, and Cochrane Library were systematically searched for randomised controlled trials (RCT) comparing the use of SMT with vs. without nebulised magnesium. The outcomes were respiratory rate, heart rate, % predicted peak expiratory flow rate (PEFR), % predicted forced expiratory volume (FEV1), peripheral O2 saturation, asthma severity scores, and need for intravenous (IV) bronchodilator use. Results: Twelve RCTs and 2484 children were included. Mean age was 5.6 (range 2-17) years old, mean baseline % predicted FEV1 was 69.6%, and 28.7% patients were male. Children treated with magnesium had a significantly higher % predicted PEFR (mean difference [MD] 5.3%; 95% confidence interval [CI] 4.75 to 5.90%; p<0.01). Respiratory rate was significantly lower in the magnesium group (MD -0.70 respirations per minute; 95% CI -1.24 to -0.15; p<0.01). Need for IV bronchodilators, % predicted FEV1, heart rate, asthma severity scores, and O2 saturation were not significantly different between groups. Conclusion: In children with asthma exacerbation, treatment with nebulised magnesium and SMT improved % predicted PEFR and led to a marginal improvement in respiratory rate as compared with SMT alone.

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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

Standard Medical Therapy With vs. Without Nebulised Magnesium for Children with Asthma Decompensation

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