IV Magnesium Sulfate for Bronchiolitis

Alansari, Khalid; Sayyed, Rafah El; Davidson, Bruce L.; Jawala, Shahaza Al; Ghadier, Mohamed

doi:10.1016/j.chest.2017.03.002

Cited by 16 publications

(23 citation statements)

References 21 publications

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“…These exclusion criteria would have made smooth muscle relaxation a plausible mechanism for the efficacy of magnesium sulfate in virus-induced wheezing in young children. A randomised controlled trial of 162 infants with a median age of 3.7 months who had bronchiolitis found that patients who received intravenous magnesium sulfate had similar mean bronchiolitis severity scores over time compared with the control group [26]. The same study found that the infants who received magnesium sulfate were more often readmitted in the 2 weeks post treatment [26].…”

Section: Discussionmentioning

confidence: 99%

Intravenous magnesium sulfate for acute wheezing in young children: a randomised double-blind trial

et al. 2018

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Magnesium sulfate has been shown to be an effective treatment in older children with asthma exacerbations, but it has not been investigated in acute severe virus-induced wheezing in young children.The study enrolled 61 children aged 6 months to 4 years. Inclusion criteria were severe wheezing, classified as a score of ≥6 points as assessed by the Respiratory Distress Assessment Instrument (RDAI) after initial treatment with salbutamol, and the symptoms of acute viral infection. The children were randomly allocated to receive either an infusion of magnesium sulfate (40 mg·kg) or 0.9% sodium chloride as a placebo infusion for 20 min. Primary outcome measure was mean change in RDAI scores from baseline to 6 h after the treatment.Change in the severity of wheezing from baseline to 6 h after the treatment, as measured by mean±sd RDAI scores, was 4.7±2.6 in the magnesium sulfate group and 4.2±4.2 in the placebo group (difference 0.5, 95% CI -1.3 to 2.3, p=0.594).Intravenous magnesium sulfate was ineffective in treating acute severe virus-induced wheezing in young children, in contrast to the previous efficacy demonstrated in older children.

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Section: Discussionmentioning

confidence: 99%

Intravenous magnesium sulfate for acute wheezing in young children: a randomised double-blind trial

et al. 2018

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“…The medical literature contains a multitude of examples of RCTs across many disease and intervention types. Some examples of recent twoarm randomized controlled trials published in CHEST are presented in Table 1 [11][12][13][14][15] to demonstrate various applications of RCTs, although these examples are not exhaustive.…”

Section: Use Cases Of Study Designmentioning

confidence: 99%

Randomized Controlled Trials

Zabor

Kaizer

Hobbs

2020

Chest

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Randomized controlled trials (RCTs) are considered the highest level of evidence to establish causal associations in clinical research. There are many RCT designs and features that can be selected to address a research hypothesis. Designs of RCTs have become increasingly diverse as new methods have been proposed to evaluate increasingly complex scientific hypotheses.This article reviews the principles and general concepts behind many common RCT designs and introduces newer designs that have been proposed, such as adaptive and cluster randomized trials. A focus on the many choices for randomization within an RCT is described, along with their potential tradeoffs. To illustrate their diversity, examples of RCTs from the literature are provided. Statistical considerations, such as power and type I error rates, are discussed with the intention of providing practical guidance about how to specify study hypotheses that address the scientific question while being statistically appropriate. Finally, the freely available Consolidated Standards of Reporting Trials guidelines and US Food and Drug Administration guidance documents are introduced, along with a set of guidelines one should consider when planning an RCT or reviewing RCTs submitted for publication in peer-reviewed academic journals.

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“…In fact, there have been only three studies, so far, evaluating the efficacy of nebulized MgSO 4 in the treatment of bronchiolitis. Alansari et al evaluated the role of intravenous magnesium sulphate in a cohort of 162 children and concluded that it did not provide any benefit [7]. Amongst the studies on nebulized MgSO 4 , noteworthy is the research by Modaresi et al [9,13].…”

Section: Discussionmentioning

confidence: 99%

“…Stipulated role of magnesium sulphate in effecting bronchodilation forms the rationale for its use in bronchial asthma. In fact, some reports indicate a superior effect even in those who are unresponsive to β-agonist treatments [ 6 , 7 ]. The clinical and pathological semblance between asthma and bronchiolitis has drawn several therapeutic analogies.…”

Section: Introductionmentioning

confidence: 99%

Nebulized Magnesium Sulphate in Bronchiolitis: A Randomized Controlled Trial

et al. 2021

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Objective To evaluate the efficacy and safety of nebulized magnesium sulphate as a bronchodilator in young children aged 1-24 mo with moderate to severe bronchiolitis in comparison to standard therapy. Methods This was an open labeled randomized controlled trial comprising 60 children with moderate to severe bronchiolitis which was randomly assigned to 2 groups. Intervention group received nebulization with 3 mL of 3.2% magnesium sulphate (MgSO 4 ) (iso-osmolar) every 4 hourly for 24 h in addition to standard care and the control group received standard care alone. The primary outcome measure was to compare the improvement of bronchiolitis severity score (BSS) and length of hospitalization. The secondary outcome was to measure the need for noninvasive ventilation, need for admission to intensive care unit (ICU) in the initial visit, to evaluate the safety of magnesium sulphate and need for clinic revisit, hospital readmission and ICU readmission within 2 wk after discharge in both the groups. Results The mean age of children allocated in the control group was 7.4 ± 5.1 mo and 7.7 ± 4.5 mo in the intervention group. There was no significant difference with respect to improvement of BSS or reduced length of hospitalization in both the groups (p > 0.05). BSS monitored sequentially after enrollment at 1, 2, 4, 8, 12, 16, and 24 h did not show statistically significant differences between the groups. Mean length of hospital stay was 2.89 ± 2.25 d in treatment group and 2.96 ± 1.86 d in control group (p = 0.902). No adverse events were observed in both the groups. Conclusion Nebulized magnesium sulphate is not superior to standard therapy in children with moderate to severe bronchiolitis.

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IV Magnesium Sulfate for Bronchiolitis

Abstract: ClinicalTrials.gov; No.: NCT02145520; URL: www.clinicaltrials.gov.

Cited by 16 publications

References 21 publications

Intravenous magnesium sulfate for acute wheezing in young children: a randomised double-blind trial

Intravenous magnesium sulfate for acute wheezing in young children: a randomised double-blind trial

Randomized Controlled Trials

Nebulized Magnesium Sulphate in Bronchiolitis: A Randomized Controlled Trial

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