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Trends in Intravenous Magnesium Use and Outcomes for Status Asthmaticus in Children's Hospitals from 2010 to 2017

Vineeta Mittal1,2, Matt Hall3, James Antoon4

  • 1Division of Pediatric Hospital Medicine, Department of Pediatrics, UT Southwestern Medical Center, Dallas, Texas.

Journal of Hospital Medicine
|June 26, 2020
PubMed

Insights

Intravenous magnesium for status asthmaticus in children doubled over 8 years. Despite increased use, it did not reduce hospital or ICU admission rates but did shorten length of stay.

Area of Science:

  • Pediatric Emergency Medicine
  • Pulmonology
  • Pharmacology

Background:

  • Intravenous (IV) magnesium sulfate is an adjunct therapy for status asthmaticus, aiming to reduce intubation rates.
  • A prior review indicated reduced admission rates with IV magnesium, contrasting with clinical observations.
  • Understanding current trends in IV magnesium use is crucial for evidence-based pediatric asthma management.

Purpose of the Study:

  • To evaluate the trends of IV magnesium use in pediatric status asthmaticus over an 8-year period.
  • To analyze the association between IV magnesium use and key clinical outcomes in children with asthma.
  • To investigate changes in hospital and intensive care unit (ICU) admission rates, length of stay, and readmission rates.

Main Methods:

  • Retrospective analysis of the Pediatric Health Information System (PHIS) database.
  • Inclusion of children younger than 18 years hospitalized for asthma.
  • Assessment of IV magnesium administration, hospital/ICU admissions, length of stay, and 7-day readmission rates.

Main Results:

  • IV magnesium use for asthma hospitalizations more than doubled, from 17% to 36% (P < .001).
  • No significant association was found between yearly trends in IV magnesium use and hospital or ICU admission rates.
  • A significant reduction in the geometric mean length of stay was observed with increased IV magnesium use (P < .001).

Conclusions:

  • The utilization of IV magnesium for pediatric status asthmaticus has significantly increased over the past decade.
  • Despite increased use, IV magnesium did not demonstrate a significant impact on reducing hospital or ICU admission rates in this cohort.
  • IV magnesium administration was associated with a reduced length of stay for pediatric asthma hospitalizations.

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