Magnesium sulfate is effective for severe acute asthma treated in the emergency department

Abstract

Magnesium sulfate is effective for severe acute asthma treated in the emergency department QUESTION What is the effectiveness of intravenous magnesium sulfate in patients with acute asthma who were treated in the emergency department? DATA SOURCES Studies were identified from the Cochrane Airways Review Group Register, MEDLINE, EMBASE/Excerpta Medica, CINAHL (Cumulative Index to Nursing and Allied Health), and the Cochrane Library. We also manually searched 20 high-quality respiratory journals and bibliographies of relevant articles and contacted authors and content experts. STUDY SELECTION Studies were selected if they were randomized controlled trials or quasi-randomized trials, included adults or children seen at an emergency department with acute asthma, and compared the use of intravenous magnesium sulfate with placebo. DATA EXTRACTION Data on study and patient characteristics, hospital admissions, pulmonary function, vital signs, and adverse events were extracted.

Oral magnesium and vitamin C supplements in asthma: a parallel group randomized placebo‐controlled trial

“…This finding conflicts with the available epidemiological and some short‐term intervention trial evidence relating to vitamin C [2, 3, 21–25] and magnesium [3, 4, 12, 13], and implies that the evidence of benefit reported in epidemiological studies may have arisen from confounding, possibly by other dietary, effects, since intakes of both vitamin C and magnesium are closely related to other nutrients found in fruits and vegetables such as flavonoids and carotenoids. Alternatively, it is possible that supplementation is effective only in subjects with a low baseline intake of these nutrients, and that the lack of effect in our study arises from the fact that baseline daily intakes in our participants were relatively high.…”

“…Epidemiological evidence suggests that dietary factors may have a significant influence on the incidence and severity of asthma [1]. Vitamin C and magnesium are two nutrients that have been particularly implicated in this respect [2–4], and intervention studies involving single doses or short‐term supplementation with vitamin C [5–11] or magnesium [12, 13] have also reported improvements in outcomes such as airflow, exercise‐induced bronchospasm and airway hyper‐responsiveness. However, there has been only one placebo‐controlled study of longer‐term use of vitamin C, which reported a decrease in clinical exacerbations of asthma during the rainy season in Nigeria, but did not provide objective data on physiological measurements [14].…”

The role of nutrition in asthma prevention and treatment

“… 25 Increased magnesium intake is associated with a positive effect on asthma. 83 , 84 In contrast, a low-salt diet improves pulmonary function in patients with exercise-induced asthma. 85 These listed nutrients, and their respective quantities, can be obtained through a plant-based diet and present a potential method for treating asthma symptoms.…”

Intravenous Magnesium as an Adjuvant in Acute Bronchospasm: A Meta-Analysis

“…This result is consistent, although not duplicative, of the findings of a recent related meta-analysis. Rowe et al 4 used the Cochrane analytic framework to examine the effect of intravenous magnesium sulfate on acute asthma. Their study excluded one trial included herein because it focuses on patients with COPD, 46 and another for reasons not made clear in the abstract, possibly because it fell outside of the search protocol.…”

“…Recently, meta-analysts affiliated with the Cochrane Group published a systematic review on the subject, concluding in a stratified analysis of 7 trials that intravenous magnesium sulfate therapy was beneficial in severe asthma. 4 Because the treating physician often cannot differentiate bronchospasm related to asthma from that caused by chronic obstructive pulmonary disease (COPD), both are included here. The purpose of this meta-analysis was to determine whether the addition of intravenous magnesium to standard therapy improves acute bronchospasm.…”