Higher-Dose Intravenous Magnesium Therapy for Children With Moderate to Severe Acute Asthma

Ciarallo, Lydia; Brousseau, David C.; Reinert, Steven E.

doi:10.1001/archpedi.154.10.979

Cited by 129 publications

(88 citation statements)

References 20 publications

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“…Using a positive study by Ciarallo et al, 27 the rate of intravenous MgSO 4 administration with a dose of 40 mg/kg for a 25-kg child during a 20-min infusion would be 50 mg/min. With the Aeroneb Go/Idehaler, the MgSO 4 aerosol delivery into the airway would be approximately one fifth that, or 11.2 mg/min, with the "infusion" lasting 16 min.…”

Section: Discussionmentioning

confidence: 99%

Testing of Nebulizers for Delivering Magnesium Sulfate to Pediatric Asthma Patients in the Emergency Department

Coates¹,

Leung²,

Vecellio

et al. 2011

Respir Care

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BACKGROUND: As the use of intravenous magnesium sulfate (MgSO 4 ) for the treatment of refractory asthma is becoming more common, the incidence of MgSO 4 -related systemic hypotension is also rising. One option is to deliver MgSO 4 via aerosol, but compared to most inhaled medications, which are active in the microgram dose range, the MgSO 4 dose requirement is in the milligram range. This, along with inefficient aerosol delivery systems, may be the reason that some studies have found lack of efficacy with aerosol MgSO 4 . In preparation for a multicenter study of inhaled MgSO 4 in asthmatic children 2-17 years old, we conducted an in vitro study to choose the best MgSO 4 nebulizer system that would be effective over the entire age range. METHODS: We tested the Pari LC Star jet nebulizer, Omron MicroAir vibrating-mesh nebulizer, and the Aeroneb Go vibrating-mesh nebulizer with the Idehaler valve-less holding chamber. Aerosol delivery was via face mask. RESULTS: The Pari LC Star had an appropriate particle size distribution but a very slow aerosol output rate. The Omron MicroAir had an even slower output rate and a larger particle size distribution, which would be inappropriate for smaller children. In vitro lung deposition with the Aeroneb Go with Idehaler was 16.0 ؎ 0.4 mg/min in older children and approximately a fifth of that in toddlers. CONCLUSIONS: The Aeroneb Go with Idehaler was chosen for the multicenter clinical study.

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Section: Discussionmentioning

confidence: 99%

Testing of Nebulizers for Delivering Magnesium Sulfate to Pediatric Asthma Patients in the Emergency Department

Coates¹,

Leung²,

Vecellio

et al. 2011

Respir Care

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“…Ciarallo e colaboradores 51 , em um ensaio clínico randomizado, placebo controlado, avaliaram a eficácia do sulfato de magnésio (40 mg/kg) em 30 pacientes (6-17,9 anos) portadores de crises agudas de asma, de intensidade moderada à grave, assistidos em dois serviços de emergência. A avaliação funcional obtida por testes de função pulmonar, considerando valores previstos para idade, foi melhor no grupo que recebeu o magnésio, tanto aos 20 minutos pós-terapêutica quanto aos 110 minutos.…”

Section: Outros Broncodilatadores: Metilxantinas E Sulfato De Magnésiounclassified

“…Cento e dez minutos: PFE (25,8% vs. 1,9%, p<0,001), VEF 1 (24,1% vs. 2,3%, p<0,001), CVF (27,3% vs. 2,6%, p<0,001). Concluíram que o sulfato de magnésio administrado a pacientes pediá-tricos portadores de crises agudas de asma (moderada a grave) é responsável por uma significativa melhora na avaliação funcional respiratória realizada em fase inicial do tratamento destes pacientes 51 .…”

Section: Outros Broncodilatadores: Metilxantinas E Sulfato De Magnésiounclassified

“…Diferente do estudo de Ciarallo 51 , administraram uma dose maior da droga (75 mg/kg) e estabeleceram, como desfecho principal para avaliação da resposta, modificação em escore clínico (índice pulmonar) realizado aos 120 minutos. Na análise dos seus resultados, não encontraram diferenças significativas nas pontuações obtidas: 2,83 para o grupo magnésio vs. 2,66 para o grupo placebo (-19% a 34% IC95%).…”

Section: Outros Broncodilatadores: Metilxantinas E Sulfato De Magnésiounclassified

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Controvérsias no manejo farmacológico da asma aguda infantil

Amantéa

Sánchez²,

Piva³

et al. 2002

J. Pediatr. (Rio J.)

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Objective: to present a review of controversial issues related to the pharmacological management of the treatment of acute asthma in children.Sources: articles published in national and international scientific journals. Data were selected from Lilacs and Medline databases.Summary of the findings: the article was organized into topics, presenting aspects on which there is consensus regarding the pharmacological treatment of asthma in children. Issues related to the use of metered dose inhaler versus nebulizers, the role of ß2-adrenergic drugs administered intravenously as well as the role of methylxanthine and magnesium sulfate are approached critically. Conclusions:Inhaled ß2-agonist drugs combined with corticosteroids remain the treatment of choice for acute episodes of asthma in children. Either nebulizers or metered dose inhalers connected to spacers are efficient for the relief of acute symptoms. Patients who are refractory to conventional treatment and develop severe acute asthma should receive ß2-agonist drugs intravenously, provided they are properly monitored. Methylxanthine and magnesium sulfate should be considered a second choice for selected patients.J Pediatr (Rio J) 2002; 78 (Supl.2): S151-S160: acute asthma, beta-agonist, magnesium sulfate, aminophylline. ResumoObjetivo: apresentar uma revisão acerca de questões controversas, relativas ao manejo farmacológico utilizado nos pacientes pediátricos portadores de asma aguda. Fontes dos dados: foram utilizadas informações de artigos publicados em revistas científicas nacionais e internacionais, selecionadas das bases de dados Lilacs e Medline.Síntese dos dados: o artigo foi estruturado em tópicos, apresentando aspectos consensuais no tratamento farmacológico da asma infantil. Questões relacionadas à utilização de inaladores dosimetrados versus nebulizadores, o papel das drogas ß 2 -adrenérgicas utilizadas pela via endovenosa, bem como das metilxantinas e do sulfato de magnésio, são abordados de maneira crítica.Conclusões: os ß 2 -agonistas administrados pela via inalatória, associados aos coricosteróides, permanecem o tratamento de eleição para episódios agudos de asma na população pediátrica. Tanto os nebulizadores quanto os inaladores dosimetrados, acoplados a espaçadores, são efetivos para alívio dos sintomas agudos. Pacientes refratários ao tratamento convencional, que evoluem para quadros de asma aguda grave, devem ter considerada a utilização de drogas ß 2 -agonistas pela via endovenosa, desde que adequadamente monitorizados. Quanto às metilxantinas e ao sulfato de magnésio, devem ser considerados alternativas secundárias para pacientes selecionados.J Pediatr (Rio J) 2002; 78 (Supl.2): S151-S160: asma aguda, beta-agonistas, sulfato de magnésio, aminofilina.

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“…It has been observed that many patient's inflammation and pain aggravated after Magnesium sulfate dressing. 5 For erysipelas and atrophic rhinitis saline compression is used. After observing pain and inflammation of Magnesium sulfate dressing, normal saline dressing is considered to be used in place of Magnesium sulfate.…”

Section: Introductionmentioning

confidence: 99%

Comparison between dressing of cellulitis with normal saline and Magnesium sulphate

Singh¹,

Sreenivasa²

2018

Int Surg J

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Background: Cellulitis is an acute inflammatory condition of the skin that is characterized by localized pain, erythema, swelling and heat. Cellulitis may be caused by indigenous flora colonies of the skin appendages.Methods: This study comprises of patients attending MNR Medical College and Hospital between February 2015 to January 2018. After proper history taking, examination and investigations patients were admitted or treated as out-patients.Results: Patients treated with normal saline dressing responded better than Magnesium sulfate dressing. No complication was observed, and healing was faster.Conclusions: In this study, author have observed patients treated with normal saline dressing responded better than Magnesium sulfate dressing. No complication was observed, and healing was faster.

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Higher-Dose Intravenous Magnesium Therapy for Children With Moderate to Severe Acute Asthma

Cited by 129 publications

References 20 publications

Testing of Nebulizers for Delivering Magnesium Sulfate to Pediatric Asthma Patients in the Emergency Department

Testing of Nebulizers for Delivering Magnesium Sulfate to Pediatric Asthma Patients in the Emergency Department

Controvérsias no manejo farmacológico da asma aguda infantil

Comparison between dressing of cellulitis with normal saline and Magnesium sulphate

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