title: IV Magnesium Sulfate for Bronchiolitis: A Randomized Trial.
abstract: The goal of this study was to determine if IV magnesium, useful for severe pediatric asthma, reduces time to medical readiness for discharge in patients with bronchiolitis when added to supportive care.
  
  
  
  We compared a single dose of 100 mg/kg of IV magnesium sulfate vs placebo for acute bronchiolitis. Patients received bronchodilator therapy, nebulized hypertonic saline, and 5 days of dexamethasone if there was eczema and/or a family history of asthma. Time to medical readiness for discharge was the primary efficacy outcome. Bronchiolitis severity scores and need for infirmary or hospital admission and for clinic revisits within 2 weeks were secondary outcomes. Cardiorespiratory instability onset was the safety outcome.
  
  
  
  A total of 162 previously healthy infants diagnosed with bronchiolitis aged 22 days to 17.6 months (median, 3.7 months) were enrolled. Approximately one-half of patients had eczema and/or a family history of asthma; 86.4% had positive findings on nasopharyngeal virus swabs. Geometric mean time until medical readiness for discharge was 24.1 h (95% CI, 20.0-29.1) for the 78 magnesium-treated patients and 25.3 h (95% CI, 20.3-31.5) for the 82 patients receiving placebo (ratio, 0.95 [95% CI, 0.52-1.80]; P = .91). Mean bronchiolitis severity scores over time were similar for the two groups. The frequency of clinic visits in the subsequent 2 weeks (33.8% and 27.2%, respectively) was also similar. Fifteen magnesium recipients (19.5%) vs five placebo recipients (6.2%) were readmitted to the infirmary or hospital within 2 weeks (P = .016). No acute cardiorespiratory side effects were reported.
  
  
  
  IV magnesium did not provide benefit for patients with acute bronchiolitis and may be harmful.
  
  
  
  ClinicalTrials.gov; No.: NCT02145520; URL: www.clinicaltrials.gov.
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar; Weill Cornell Medical College, Doha, Qatar; Division of Pediatric Emergency Medicine, Department of Pediatrics, Sidra Medical and Research Center, Doha, Qatar. Electronic address: dkmaa@hotmail.com.
authors.forename: Khalid
authors.initials: K
authors.lastname: Alansari
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Rafah
authors.initials: R
authors.lastname: Sayyed
authors.affiliation: Pulmonary and Critical Care Medicine Division, University of Washington School of Medicine, Seattle, WA.
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Davidson
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Shahaza
authors.initials: S
authors.lastname: Al Jawala
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ghadier
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001988:Bronchiolitis / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000009:adverse effects; D003907:Dexamethasone / Q000627:therapeutic use; D016903:Drug Monitoring / Q000379:methods; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D008278:Magnesium Sulfate / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D002121:Calcium Channel Blockers; D008278:Magnesium Sulfate; D003907:Dexamethasone
keywords: bronchiolitis; length of stay; magnesium sulfate; respiratory infections; respiratory syncytial virus