High-dose intravenous magnesium sulfate in the management of life-threatening status asthmaticus

Abstract

In severe status asthmaticus basic medical treatment often fails to improve the patient's condition. Mechanical ventilation in this situation is associated with a high incidence of serious complications. After the bronchodilating effect of moderate-dose magnesium sulfate in asthmatic patients had been demonstrated in previous studies we treated five mechanically ventilated patients with refractory status asthmaticus successfully with high dosages of MgSO4 IV (10-20 g within 1 h depending on the bronchodilating effect). MgSO4 resulted in a significant decrease of peak airway pressure (43.0 +/- 6.8 to 32.0 +/- 8.0 cmH2O) and inspiratory flow resistance (22.7 +/- 7.0 to 11.9 +/- 6.0 cmH2O.l-1.s-1) within 1 h. The resulting serum magnesium levels after one hour were up to threefold of the normal serum levels. Although a maintainance dose of 0.4 g/h had been administered continuously during the following 24 h serum magnesium decreased towards normal values within this time. The only relevant side-effect was a mild to moderate arterial hypotension in two of the five patients during the high dose administration period of MgSO4 which responded readily to dopamine treatment.

A Double-Blind Placebo-Controlled Crossover Trial of Intravenous Magnesium Sulfate for Foscarnet-Induced Ionized Hypocalcemia and Hypomagnesemia in Patients with AIDS and Cytomegalovirus Infection

“…Second, the failure to detect any effect of MgSO 4 on the fall in iCa 2ϩ concentrations following foscarnet infusion was perhaps due to inadequate dosing. Other studies have used substantially higher MgSO 4 doses to achieve Ͼ3-fold increases in blood magnesium concentrations compared to baseline values (14,16,37). The maximal dose of MgSO 4 used in this study, however, did not quite double the mean serum magnesium concentrations (Fig.…”

“…Extensive clinical use has confirmed the safety of rapid administration of large doses of MgSO 4 . Typically, only small decreases in blood pressure are seen (14,37), although hypotension, decreased respiration, vomiting, neuromuscular blockade, and coma have been reported (14,30,37).…”

Comparison between dressing of cellulitis with normal saline and Magnesium sulphate

“…Acc to St Louis children hospital wet dressing may be ordered to help treat the cellulitis. 3 Cool water soaks or compresses causes vessels to constrict, get small which helps lessens inflammation that is swelling, pain and redness. 10 According to Dr Axe, when antibacterials and antibiotics prevent the immune system from learning how to defend against invaders, the immune system can remain highly reactive throughout the adult years.…”

“…Erysipelas and cellulitis often co-exist. 3 Cellulitis is the non-suppurative invasive infection of tissue. Cellulitis occur as bacteria gain access to the epidermis through cracks in the skin, abrasion, cuts, burns, insect bites, surgical incision and intravenous cathedral.…”

Use of Intravenous Magnesium Sulfate for the Treatment of an Acute Asthma Exacerbation in Pediatric Patients

“…The practice of continuous infusion is supported by 1 retrospective study in children 8 as well as some case reports in adult patients 15,16 and focuses on maintaining constant magnesium concentrations instead of peaks and troughs. The retrospective chart review, conducted by Glover and colleagues, 8 evaluated a total of 40 patients who were treated with intravenous magnesium sulfate for an acute asthma exacerbation.…”