Usefulness of inhaled magnesium sulfate in the coadjuvant management of severe asthma crisis in an emergency department

Gallegos-Solórzano, M.C.; Pérez‐Padilla, Rogelio; Hernández-Zenteno, Rafael de Jesús

doi:10.1016/j.pupt.2010.04.006

Cited by 44 publications

(32 citation statements)

References 23 publications

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“…A Cochrane meta-analysis of 7 studies concluded that IV magnesium sulfate improves pulmonary function and reduces hospital admissions, particularly for patients with the most severe exacerbations of asthma. 20 The use of nebulized magnesium sulfate as an adjunct to nebulized ␤-adrenergic agents has been reported in a small case series to improve FEV1 and SpO 2 , 21 although a prior meta-analysis demonstrated only a trend toward improved pulmonary function with nebulized magnesium. 22 For those with severe refractory asthma, providers may consider IV magnesium at the standard adult dose of 2 g administered over 20 minutes.…”

Section: Magnesium Sulfatementioning

confidence: 99%

Part 12: Cardiac Arrest in Special Situations

Hoek¹,

Morrison²,

Shüster³

et al. 2010

Circulation

650

437

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Section: Magnesium Sulfatementioning

confidence: 99%

Part 12: Cardiac Arrest in Special Situations

Hoek¹,

Morrison²,

Shüster³

et al. 2010

Circulation

650

437

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“…Ipratropium bromide (a short-acting anticholinergic) and SABA are associated with fewer hospitalizations and greater improvement in PEF and FEV 1 compared with SABA alone [150]. In patients with FEV 1 < 25-30% predicted at presentation and those who fail to respond to initial treatment and have persistent hypoxia, intravenous magnesium sulfate (2 g infusion over 20 min) should be considered (evidence A) [151,152]. The evidence regarding the role of noninvasive ventilation is weak and no specific recommendation has been made in this regard.…”

Section: Management Of Exacerbations In the Emergency Departmentmentioning

confidence: 99%

Diagnosis and Management of Asthma – The Swiss Guidelines

et al. 2018

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The Global Initiative for Asthma (GINA) is a network of individuals, organizations, and public health officials that was established to disseminate information about the care of patients with asthma and to improve asthma care. The GINA (“Global Strategy for Asthma Management and Prevention”) report has been updated annually since 2002. Due to new knowledge and therapeutic development in the field, the Swiss Respiratory Society felt the need to provide a new document that is based on both the available literature and the recommendations of the 2016 GINA report. Key new features of the 2016 GINA report include a “new” definition of asthma, underscoring its heterogeneous nature, and the core elements of variable symptoms and variable expiratory airflow limitation; the importance of confirming the diagnosis of asthma in order to minimize both under- and overtreatment; practical tools for the assessment of symptom control and risk factors for adverse outcomes; a comprehensive approach to asthma management that acknowledges the foundational role of inhaled corticosteroid therapy, but also provides a framework for individualizing patient care; an emphasis on maximizing the benefit of available medications by addressing common problems such as incorrect inhaler technique and poor adherence; a continuum of care for worsening asthma, starting with early self-management and progressing to primary care or acute care management; and diagnosis of the asthma/chronic obstructive pulmonary disease overlap syndrome. This document is meant to advice the key stakeholders on the diagnosis and management of asthma and highlights the need to individualize the care of each and every asthmatic patient.

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“…Intravenous magnesium sulfate is not recommended for routine use in asthma exacerbations; however, when administered as a single 2 g infusion over 20 minutes, it reduces hospital admissions in some patients, including adults with FEV 1 <25-30% predicted at presentation; adults and children who fail to respond to initial treatment and have persistent hypoxemia; and children whose FEV 1 fails to reach 60% predicted after 1 hour of care [383][384][385] (Evidence A). A large, randomized, controlled trial showed no benefit with the addition of intravenous or nebulized magnesium compared with placebo in the routine care of asthma exacerbations, but those with more severe exacerbations were excluded.…”

Section: Magnesiummentioning

confidence: 99%