title: Randomised comparison of intravenous magnesium sulphate, terbutaline and aminophylline for children with acute severe asthma.
abstract: OBJECTIVE
  This study compared the efficacy of intravenous magnesium sulphate, terbutaline and aminophylline for children with acute, severe asthma poorly responsive to standard initial treatment.
  
  
  METHODS
  We enrolled 100 children, aged one to 12 years, who had failed to respond to initial standard treatment for acute, severe asthma, in this randomised controlled trial. They received either intravenous magnesium sulphate, terbutaline or aminophylline. Responses were monitored using a modified Clinical Asthma Severity (CAS) score. The primary outcome was treatment success, defined as a reduction in the CAS of four points or more 1 h after starting the intervention.
  
  
  RESULTS
  The magnesium sulphate group had higher treatment success (33/34, 97%) than the terbutaline and aminophylline groups (both 23/33, 70%) (p = 0.006) and faster resolution of retractions, wheeze and dyspnoea (p < 0.001). No adverse events occurred among patients receiving magnesium sulphate, but two patients receiving terbutaline had hypokalemia and nine patients receiving aminophylline had nausea and, or, vomiting.
  
  
  CONCLUSIONS
  Adding a single dose of Intravenous magnesium sulphate to inhaled beta2-agonists and corticosteroids was more effective, and safer, than using terbutaline or aminophylline when treating a child with acute severe asthma poorly responsive to initial treatment.
authors.affiliation: Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sunit
authors.initials: S
authors.lastname: Singhi
authors.forename: Sudhanshu
authors.initials: S
authors.lastname: Grover
authors.forename: Arun
authors.initials: A
authors.lastname: Bansal
authors.forename: Kapil
authors.initials: K
authors.lastname: Chopra
mesh_terms: D000208:Acute Disease; D061605:Administration, Intravenous; D000628:Aminophylline / Q000008:administration & dosage*; D000700:Analgesics / Q000008:administration & dosage*; D001249:Asthma / Q000150:complications / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008278:Magnesium Sulfate / Q000008:administration & dosage*; D008297:Male; D013726:Terbutaline / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D001993:Bronchodilator Agents; D000628:Aminophylline; D008278:Magnesium Sulfate; D013726:Terbutaline
keywords: Acute asthma; Aminophylline; Children; Magnesium sulphate; Terbutaline