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Published on: April 6, 2017
Nebulized Magnesium Sulphate in Bronchiolitis: A Randomized Controlled Trial
Roma Debbarma1, Daisy Khera2, Surjit Singh3
1Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajathan, India.
Insights
Nebulized magnesium sulfate showed no significant benefit over standard care for treating moderate to severe bronchiolitis in infants. This study found no improvement in severity scores or hospital stay duration for the magnesium sulfate group.
Area of Science:
- Pediatrics
- Pulmonology
- Pharmacology
Background:
- Bronchiolosis is a common viral respiratory infection in infants.
- Standard treatment for bronchiolitis primarily involves supportive care.
- Investigating novel bronchodilators like magnesium sulfate is crucial for improving outcomes.
Purpose of the Study:
- To assess the efficacy of nebulized magnesium sulfate as a bronchodilator in young children (1-24 months) with moderate to severe bronchiolitis.
- To compare the effectiveness of magnesium sulfate plus standard therapy against standard therapy alone.
- To evaluate the safety profile of nebulized magnesium sulfate in this pediatric population.
Main Methods:
- An open-label, randomized controlled trial involving 60 children with moderate to severe bronchiolitis.
- Intervention group received nebulized magnesium sulfate (3 mL of 3.2% iso-osmolar solution) every 4 hours for 24 hours alongside standard care.
- Control group received standard care only. Primary outcomes included bronchiolitis severity score (BSS) and length of hospitalization.
Main Results:
- No statistically significant difference was observed in the improvement of BSS between the magnesium sulfate and control groups.
- The length of hospitalization was similar in both groups, with a mean of 2.89 days for the treatment group and 2.96 days for the control group.
- No adverse events were reported in either group, indicating a favorable safety profile for nebulized magnesium sulfate.
Conclusions:
- Nebulized magnesium sulfate does not demonstrate superiority over standard therapy for managing moderate to severe bronchiolitis in infants.
- Further research may be needed to explore alternative dosages or treatment durations.
- Standard supportive care remains the primary treatment approach for bronchiolitis.
Objective:
To evaluate the efficacy and safety of nebulized magnesium sulphate as a bronchodilator in young children aged 1-24 mo with moderate to severe bronchiolitis in comparison to standard therapy.
Methods:
This was an open labeled randomized controlled trial comprising 60 children with moderate to severe bronchiolitis which was randomly assigned to 2 groups. Intervention group received nebulization with 3 mL of 3.2% magnesium sulphate (MgSO4) (iso-osmolar) every 4 hourly for 24 h in addition to standard care and the control group received standard care alone. The primary outcome measure was to compare the improvement of bronchiolitis severity score (BSS) and length of hospitalization. The secondary outcome was to measure the need for noninvasive ventilation, need for admission to intensive care unit (ICU) in the initial visit, to evaluate the safety of magnesium sulphate and need for clinic revisit, hospital readmission and ICU readmission within 2 wk after discharge in both the groups.
Results:
The mean age of children allocated in the control group was 7.4 ± 5.1 mo and 7.7 ± 4.5 mo in the intervention group. There was no significant difference with respect to improvement of BSS or reduced length of hospitalization in both the groups (p > 0.05). BSS monitored sequentially after enrollment at 1, 2, 4, 8, 12, 16, and 24 h did not show statistically significant differences between the groups. Mean length of hospital stay was 2.89 ± 2.25 d in treatment group and 2.96 ± 1.86 d in control group (p = 0.902). No adverse events were observed in both the groups.
Conclusion:
Nebulized magnesium sulphate is not superior to standard therapy in children with moderate to severe bronchiolitis.
Clinical Trial Registration Number:
CTRI/2018/06/014400.
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