Nebulized magnesium for moderate and severe pediatric asthma: A randomized trial
What this study found
Nebulized magnesium sulfate did not improve the main clinical outcome of time to medical readiness for discharge. Time to readiness was 14.7 hr (SD 9.7) with MgSO4 versus 15.6 hr (SD 11.3) with placebo, with OR 1.14, 95% CI 0.93 to 1.40, P = 0.20. Magnesium levels rose modestly after treatment, from 0.82 to 0.85 mmol/L, P = 0.001, but this biochemical change did not translate into better clinical outcomes. Other outcomes, including readiness by 8, 12, 24, 36, and 48 hr and short-term revisits or admission, were also similar overall, and no important adverse effects were identified.
- Study & population
- Randomized trial in children aged 2 to 14 years with moderate to severe asthma exacerbations admitted for infirmary or observation unit care in Qatar.
- Intervention
- The active regimen was nebulized magnesium sulfate, 800 mg in 15 mL, delivered by nebulization in three doses during the second hour of treatment using an Aeroneb Pro with an Idehaler holding chamber.
- Key limitation
- Single-center study in an acute-care pediatric setting, which limits generalizability.
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Open PDFOriginal abstract
Intravenous magnesium sulfate, a rescue therapy added to bronchodilator and systemic steroid therapy for moderate and severe asthma, is uncommonly administered. We hypothesized that nebulized magnesium would confer benefit without undue risk.