Effectiveness of magnesium sulfate as initial treatment of acute severe asthma in children. A randomized, controlled trial

Torres, Silvio; Sticco, Nicolás; Bosch, Juan; Iolster, Tomás; Siaba, Alejandro; Rivarola, Manuel Rocca; Schnitzler, Eduardo

doi:10.5546/aap.2012.eng.291

Cited by 29 publications

(31 citation statements)

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“…Studies involving young children suggest a superior effect than aminophylline and terbutaline but not to salbutamol and that an early administration is associated with fewer patients requiring mechanical ventilatory support (invasive or noninvasive) (23)(24)(25). However, several authors suggest a need of higher dose regimens (9,20,21,23), and multicenter studies have failed to show a consistent decrease in hospital admissions or early discharge (4,21,22). We found superiority of HDMI over MgSO 4 bolus in inducing a shorter LOS when used as an early ED adjunctive therapy in older children and adolescents with severe noninfectious asthma.…”

Section: Discussionmentioning

confidence: 97%

“…Since its original description, the optimal regimen of MgSO 4 in severe asthma has not been established, leading to the utilization of a wide dosing range, route of administration, and scenarios (18)(19)(20)(21)(22)(23)(24). Studies involving young children suggest a superior effect than aminophylline and terbutaline but not to salbutamol and that an early administration is associated with fewer patients requiring mechanical ventilatory support (invasive or noninvasive) (23)(24)(25).…”

Section: Discussionmentioning

confidence: 97%

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High-Dose Magnesium Sulfate Infusion for Severe Asthma in the Emergency Department

Irazuzta

Paredes

Pavlicich

et al. 2016

Pediatric Critical Care Medicine

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

High-Dose Magnesium Sulfate Infusion for Severe Asthma in the Emergency Department

Irazuzta

Paredes

Pavlicich

et al. 2016

Pediatric Critical Care Medicine

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“…The use of iv magnesium given during the first hour of presentation in a recent randomized study of 143 children with AEA significantly reduced the need for mechanical ventilation (33 vs. 5 %, P=0.001) [91]. Improved outcomes in adults and children with AEA treated with iv magnesium are reported in several systematic reviews and meta-analyses [89,90,92].…”

Section: Magnesium Sulfatementioning

confidence: 93%

The Acute Management of Asthma

Albertson

Sutter

Chan

2014

Clinic Rev Allerg Immunol

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Patients presenting to the emergency department (ED) or clinic with acute exacerbation of asthma (AEA) can be very challenging varying in both severity and response to therapy. High-dose, frequent or continuous nebulized short-acting beta2 agonist (SABA) therapy that can be combined with a short-acting muscarinic antagonist (SAMA) is the backbone of treatment. When patients do not rapidly clinically respond to SABA/SAMA inhalation, the early use of oral or parenteral corticosteroids should be considered and has been shown to impact the immediate need for ICU admission or even the need for hospital admission. Adjunctive therapies such as the use of intravenous magnesium and helium/oxygen combination gas for inhalation and for driving a nebulizer to deliver a SABA and or SAMA should be considered and are best used early in the treatment plan if they are likely to impact the patients' clinical course. The use of other agents such as theophylline, leukotriene modifiers, inhaled corticosteroids, long-acting beta2 agonist, and long-acting muscarinic antagonist currently does not play a major role in the immediate treatment of AEA in the clinic or the ED but is an important therapeutic option for physicians to be aware of and to consider initiating at the time of discharge from clinic, hospital, or ED to reduce later clinical worsening and readmission to the ED and hospital. A comprehensive summary is provided of the currently available respiratory pharmaceuticals approved for asthma and other airway syndromes. Clinicians must be prepared to use the entire spectrum of medications available for the treatment of acute asthma exacerbations and the agents that should be initiated to prevent worsening or additional exacerbations. They need to be familiar with the major potential drug toxicities associated with their use.

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“…There were no cases of ‘clinical hypermagnesemia’ related to treatment overdosing (almost exclusively in patients with renal dysfunction). Therefore, MgSO 4 appears to present an optimal safety profile .…”

Section: Therapeutic Index and Cost‐effectivenessmentioning

confidence: 97%

Magnesium sulfate in pediatric anesthesia: the Super Adjuvant

Rebollar

Palacios

Guerrero

et al. 2017

Pediatric Anesthesia

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Magnesium is an essential chemical element in all organisms, intervening in most cellular enzymatic reactions; thus, its importance in homeostasis and as a therapeutic tool in highly challenging patients such as pediatrics. The primary purpose of this paper was to review the role of magnesium sulfate as an adjuvant drug in pediatric anesthesia. This compound already has the scientific backing in certain aspects such as analgesia or muscle relaxation, but only theoretical or empirical backing in others such as organ protection or inflammation, where it seems to be promising. The multitude of potential applications in pediatric anesthesia, its high safety, and low cost make magnesium sulfate could be considered a Super Adjuvant.

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Effectiveness of magnesium sulfate as initial treatment of acute severe asthma in children. A randomized, controlled trial

Cited by 29 publications

References 1 publication

High-Dose Magnesium Sulfate Infusion for Severe Asthma in the Emergency Department

High-Dose Magnesium Sulfate Infusion for Severe Asthma in the Emergency Department

The Acute Management of Asthma

Magnesium sulfate in pediatric anesthesia: the Super Adjuvant

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