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Intravenous magnesium for acute asthma: failure to decrease emergency treatment duration or need for hospitalization
1Department of Emergency Medicine, Riverside General Hospital, California.
Study Objective:
To evaluate the efficacy of routine early administration of i.v. magnesium to patients with acute asthma.
Design:
Prospective, randomized clinical trial.
Setting:
Urban teaching hospital emergency department.
Type Of Participants:
One hundred twenty consecutive patients aged 18 to 65 years with acute asthma unresponsive to a single albuterol treatment.
Interventions:
All patients received oxygen, 125 mg i.v. methylprednisolone, and hourly albuterol inhalation therapy. The study group also received 2 g i.v. magnesium sulfate infused over 20 minutes.
Measurements And Main Results:
Demographic and clinical characteristics were similar in both groups. Hospitalization was necessary in 13 of 58 patients who received magnesium (22%; 95% confidence intervals [CI], 13% to 32%) and 11 of 62 control patients (17%; 95% CI 10% to 26%; P = .523). Duration of ED treatment in discharged patients was 224 +/- 75 minutes in the magnesium group (95% CI, 208 to 240 minutes) and 228 +/- 90 minutes in the control group (95% CI, 209 to 247 minutes, P = .832). In addition, changes in peak expiratory flow were not statistically different.
Conclusion:
Routine early administration of IV magnesium in acute asthma does not alter treatment outcome.