Magnesium sulfate administered via continuous intravenous infusion in pediatric patients with refractory wheezing.
OBJECTIVE
To evaluate the dosing and safety of intravenous magnesium sulfate administered via continuous infusion for refractory wheezing.


METHODS
All patients admitted to the pediatric intensive care unit (PICU) between January 1998 and March 2001 who were prescribed magnesium sulfate via continuous infusion were identified via retrospective chart review. The patient's medical history, demographic data, vital signs, magnesium dosing history, and concurrent medications were recorded.


RESULTS
Forty PICU patients represent our study population. The mean age was 82.6 +/- 64.6 mo; 18 patients were boys.The mean magnesium loading dose (mg/kg) was 29.6 +/- 13.2 with a mean infusion dose (mg/kg/h) of 18.4 +/- 6.5 with a significant difference in dosing noted between patients weighing less than 30 kg and those with a higher weight. The mean magnesium loading dose (mg/kg) in the less than 30 kg group was 35.3 +/- 12.7 compared with 21.9 +/- 9.9 in the higher weight group (P <.05). Mean infusion doses (mg/kg/h) were 21.6 +/- 6 and 14.6 +/- 4.2, respectively (P <.05). There was no significant difference between the mean concentrations (mg/dL) reported between the 2 groups (less than 30 kg group = 3.9 +/- 0.6; higher weight group = 3.6 +/- 0.5). All patients received nebulized albuterol, ipratropium, and intravenous methylprednisolone before magnesium therapy. Aminophylline and ketamine were prescribed to 28 and 4 patients, respectively. No cardiovascular adverse effects were noted during magnesium therapy.


CONCLUSIONS
For the treatment of refractory wheezing, intravenous magnesium sulfate administered via continuous infusion represents a safe mode of drug delivery.
Glover
Mark L
ML
College of Pharmacy, Nova Southeastern University, Ft Lauderdale, FL 33155-3009, USA.
Machado
Cary
C
Totapally
Balagangadhar R
BR
D000293:Adolescent; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D015278:Intensive Care Units, Pediatric; D008278:Magnesium Sulfate / Q000008:administration & dosage*; D008297:Male; D012135:Respiratory Sounds / Q000503:physiopathology*; D012189:Retrospective Studies; D014481:United States
D001993:Bronchodilator Agents; D008278:Magnesium Sulfate