Magnesium sulfate infusion for acute asthma in the emergency department

Irazuzta, José; Chiriboga, Nicolas

doi:10.1016/j.jpedp.2017.08.007

Cited by 9 publications

(15 citation statements)

References 35 publications

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“…The ideal level of serum magnesium for the treatment of wheezing exacerbations in childhood is not well established in the literature. Several studies have reported achieving therapeutic efficacy with serum concentrations between 3 and 5 mg/dL, corroborating the data found in this study in which the median serum magnesium was 4.3 (3.9-4.6) after 4 hours of infusion (13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Discussionsupporting

confidence: 91%

“…Magnesium produces smooth muscle relaxation inducing bronchodilation and has a rapid peak of action, but is also rapidly eliminated by the kidney, which restricts its use. In order to prolong the effect of magnesium sulfate, maintaining a compatible therapeutic level to compensate for the rapid elimination, Irazuzta et al suggested the continuous infusion of this medication (16,19,20).…”

Section: Discussionmentioning

confidence: 99%

“…As a strategy to maintain a consistent therapeutic serum level to compensate for rapid renal elimination, some researchers have proposed the continued use of magnesium sulfate intravenously (14)(15)(16)(17)(18)(19)(20). In a recent study carried out by Irazuzta and collaborators, they demonstrated that the use of magnesium sulfate, at a dose of 50mg/kg/hour for 4 hours when compared to bolus treatment (50mg/kg/hour in 1 hour), had better results in the time of disease progression, improvement in lung function, reduction in the hospitalization rate and a better cost-benefit ratio (17).…”

Section: Introductionmentioning

confidence: 99%

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Use of Magnesium Sulfate in Continuous Infusion in Patients With Severe Acute Asthma, in a Pediatric Emergency Room

nior

Lago

Santana

et al. 2020

Preprint

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Introduction: Asthma is a disease with important morbidity and that can lead to death in childhood. The use of intravenous magnesium sulfate has been indicated in cases refractory to the initial management with inhaled bronchodilators and corticosteroids. Objective: To evaluate the use of magnesium sulfate in continuous infusion (50mg/kg/hour in 4 hours) in children with severe acute asthma. Location: 10-bed pediatric emergency room, university hospital. Patients: Children over 2 years old who received a continuous infusion of magnesium sulfate at a dose of 50mg/kg/hour in 4 hours. Methods and main findings: Cross-sectional, prospective study. All patients with severe acute asthma were included in a study protocol. A total of 40 patients met the inclusion criteria, 60% male, with a median age of 3.0 years (2.8-4.3). All patients were monitored and followed by an emergency pediatrician during the 4 hours of infusion. There was no description of adverse events related to the magnesium sulfate. The modified Wood-Downes clinical score was applied and compared before and after the infusion and a significant clinical improvement was observed (p<0.001). The serum magnesium levels at the end of the infusion ranged from 3.3-5.8 mg/dL, suitable as therapeutic and without toxicity (median 4.0). The median length of stay in pediatric emergency was 2 days. Only 2 patients (5%) were transferred to the PICU. Conclusions: On this study, the use of continuous magnesium sulfate proved to be well tolerated, leading to improved respiratory status, and can be considered as adjunctive therapy in the management of severe asthma.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of Magnesium Sulfate in Continuous Infusion in Patients With Severe Acute Asthma, in a Pediatric Emergency Room

nior

Lago

Santana

et al. 2020

Preprint

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“…Several studies have reported that systemic administration of MgSO 4 in adults with moderate to severe acute asthma resulted in significantly improved short-term pulmonary function [8,9]. Although most studies examining the potential clinical role of MgSO 4 treatment in children with acute asthma have shown beneficial effect, its precise role has still not been fully elucidated [10][11][12][13][14][15]. In this regard, two meta-analyses examined the role of IV MgSO 4 for acute severe asthma as part of the co-therapies with inhaled β 2 agonists and systemic steroids mainly conducted in the pediatric emergency department [16,17].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Magnesium Sulfate Treatment in Children with Acute Asthma

Özdemir

Doğruel

2020

Med Princ Pract

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Significance of the Study• This study investigates the efficacy of systemic magnesium sulfate treatment in asthmatic children with a considerable number of patients. • It appears to have a beneficial bronchodilator response by providing sufficient bronchodilator effect on pulmonary function parameters in children with acute asthma. • Systemic magnesium sulfate may be considered for patients with acute asthma attack.

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“…MgSO 4 could inhibit acetylcholine release at the motor nerve terminals, inhibit histamine release from mast cells, and decrease mucus production in the secretory glands 22,23. MgSO 4 could enhance the effect of other bronchodilators without causing significant changes in vital signs or adverse effects 24.…”

mentioning

confidence: 99%

Intraoperative MgSO₄ infusion protects oxygenation and lung mechanics in COPD patients during general anesthesia. A randomized clinical trial

Ahmed

Sayed

El-Kholy

et al. 2020

Acta Anaesthesiol Scand

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Background: The purpose of this study was to examine the effects of an intraoperative MgSO 4 infusion on arterial oxygenation and lung mechanics in patients with moderate COPD undergoing cancer larynx surgery under general anesthesia (GA). Our primary outcome was arterial oxygenation determined by the PaO 2 and PaO 2 / FiO 2. The secondary outcomes were lung mechanics (peak airway pressure, airway plateau pressure, dead space, lung compliance, airway resistance) and postoperative complications. Methods: In this randomized controlled double-blinded trial, 40 patients with an ASA classifications II and/or III who were diagnosed with moderate COPD and who were scheduled for cancer larynx surgery under GA were randomly allocated into two equal groups, the target (Mg group) and control group (C group). In the Mg group, 30 mg/kg of 10% MgSO 4 solution was administered intravenously for over 20 minutes as the loading dose, followed by the continuous infusion of 10 mg/kg/hr In the C group, the same loading and maintenance infusion rates were administered using 0.9% saline. Results: Unlike the C group (baseline "T0" to post-infusion "T1" interval 294 ± 97 vs 238 ± 71 mm Hg, respectively, P = .04 ± SD), the Mg group exhibited preserved intraoperative PaO 2 (T0 to T1 interval 271 ± 89 vs 257 ± 53 mm Hg, respectively, P = .54 ± SD) and PaO 2 /FiO 2 (C group T0 to T1 interval 404 ± 81 vs 349 ± 84, P = .04 and Mg group 394 ± 91 vs 379 ± 95, P = .61, respectively), and these effects were modest. Further, compared to the C group, the Mg group exhibited lower airway resistance, dead space, airway plateau pressure, and peak airway pressure, and higher dynamic compliance. The postoperative PaO 2 and PaO 2 /FiO 2 were higher in the Mg group compared to the C group. Conclusions: Intraoperative infusion of MgSO 4 in patients with moderate COPD undergoing laryngectomy surgery under GA produces mild perioperative protective effects on both arterial oxygenation and lung mechanics.

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Magnesium sulfate infusion for acute asthma in the emergency department

Cited by 9 publications

References 35 publications

Use of Magnesium Sulfate in Continuous Infusion in Patients With Severe Acute Asthma, in a Pediatric Emergency Room

Use of Magnesium Sulfate in Continuous Infusion in Patients With Severe Acute Asthma, in a Pediatric Emergency Room

Efficacy of Magnesium Sulfate Treatment in Children with Acute Asthma

Intraoperative MgSO₄ infusion protects oxygenation and lung mechanics in COPD patients during general anesthesia. A randomized clinical trial

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Magnesium sulfate infusion for acute asthma in the emergency department

Cited by 9 publications

References 35 publications

Use of Magnesium Sulfate in Continuous Infusion in Patients With Severe Acute Asthma, in a Pediatric Emergency Room

Use of Magnesium Sulfate in Continuous Infusion in Patients With Severe Acute Asthma, in a Pediatric Emergency Room

Efficacy of Magnesium Sulfate Treatment in Children with Acute Asthma

Intraoperative MgSO4 infusion protects oxygenation and lung mechanics in COPD patients during general anesthesia. A randomized clinical trial

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Product

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Intraoperative MgSO₄ infusion protects oxygenation and lung mechanics in COPD patients during general anesthesia. A randomized clinical trial