Inhaled magnesium sulfate in the treatment of acute asthma.

Study answer

What this study found

Nebulized magnesium sulfate may provide modest short-term improvements in lung function and may slightly reduce admission when added to inhaled beta-agonists and ipratropium, but the overall evidence is low certainty and larger trials generally did not show clinically important benefit. In pooled analyses, admission with MgSO4 + SABA + ipratropium was RR 0.95, 95% CI 0.91 to 1.00, and % predicted FEV1 with MgSO4 + SABA was MD 3.34, 95% CI -1.58 to 8.26. Small-study signals favored magnesium for some spirometry outcomes, including a pooled MD 3.28, 95% CI 1.06 to 5.49 in two smaller studies,…

Study & population

Systematic review and meta-analysis of randomized trials in adults and children with acute asthma exacerbations treated in acute care settings, usually emergency departments.

Intervention

Nebulized magnesium sulfate was administered by inhalation, most often as an adjunct to inhaled salbutamol with or without ipratropium bromide, and in some trials as magnesium sulfate alone versus inhaled beta-agonist.

Key limitation

Confidence in the evidence was low, with substantial heterogeneity, variable dosing and comparators, and inconsistent outcome reporting across trials.

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Original abstract