Higher-dose intravenous magnesium therapy for children with moderate to severe acute asthma.
OBJECTIVE
To evaluate the efficacy of a 40-mg/kg dose of intravenous magnesium sulfate for moderate to severe asthma exacerbations in pediatric patients.


METHODS
Double-blind placebo-controlled trial.


METHODS
Two urban tertiary care pediatric emergency departments.


METHODS
Thirty patients, aged 6 to 17.9 years, being treated for an acute asthma exacerbation.


METHODS
Eligible patients received either a magnesium sulfate infusion of 40 mg/kg or saline solution.


RESULTS
At 20 minutes, the time at which the infusion was completed, the magnesium group had a significantly greater percentage of absolute improvement from baseline in each of the following: predicted peak expiratory flow rate (8.6% vs 0.3%, P<. 001), forced expiratory volume in 1 second (7.0% vs 0.2%,P<.001), and forced vital capacity (7.3% vs -0.7%, P<.001). The improvement was greater at 110 minutes: peak expiratory flow rate (25.8% vs 1.9%, P<.001), forced expiratory volume in 1 second (24.1% vs 2.3%; P<. 001), and forced vital capacity (27.3% vs 2.6%, P<.001). Patients who received intravenous magnesium were more likely to be discharged to their homes than those who received the placebo (8/16 vs 0/14; P=. 002).


CONCLUSIONS
Children treated with 40 mg/kg of intravenous magnesium sulfate for moderate to severe asthma showed remarkable improvement in short-term pulmonary function.
Ciarallo
L
L
Department of Pediatrics, Brown University School of Medicine, Providence, RI, USA.
Brousseau
D
D
Reinert
S
S
D000293:Adolescent; D001249:Asthma / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D002121:Calcium Channel Blockers / Q000008:administration & dosage* / Q000494:pharmacology; D002648:Child; D004311:Double-Blind Method; D004638:Emergency Treatment / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D008278:Magnesium Sulfate / Q000008:administration & dosage* / Q000494:pharmacology; D008297:Male; D010366:Peak Expiratory Flow Rate / Q000187:drug effects; D012720:Severity of Illness Index; D013997:Time Factors; D014797:Vital Capacity / Q000187:drug effects
D002121:Calcium Channel Blockers; D008278:Magnesium Sulfate