Related Experiment Video
Updated: Jul 2, 2025
Methodology for Sputum Induction and Laboratory Processing
Published on: December 17, 2017
Intravenous magnesium sulfate for asthma exacerbations in children: Systematic review with meta-analysis
Dominika Ambrożej1, Aleksander Adamiec1, Erick Forno2
1Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland; Doctoral School, Medical University of Warsaw, Warsaw, Poland.
Insights
Intravenous magnesium sulfate (IV-MgSO4) reduces hospitalization and improves lung function in children with asthma exacerbations. Adverse effects were rare, but further research is needed for definitive conclusions.
Area of Science:
- Pediatric Pulmonology
- Clinical Pharmacology
Background:
- Asthma is a leading chronic childhood illness, posing a significant healthcare challenge.
- Current first-line treatments for acute asthma exacerbations are established, but secondary treatments like IV-MgSO4 lack robust data on efficacy and safety.
Purpose of the Study:
- To evaluate the effectiveness and safety of intravenous magnesium sulfate (IV-MgSO4) as a secondary treatment for pediatric asthma exacerbations.
Main Methods:
- A systematic review and meta-analysis of randomized clinical trials (RCTs) published up to April 2023.
- Searched five databases for studies on IV-MgSO4 in children with acute asthma exacerbations.
- Primary outcomes included hospitalization rates, length of stay, and severity scores; secondary outcomes covered lung function (PEFR), re-admissions, PICU needs, and adverse events.
Main Results:
- Eleven studies were included. IV-MgSO4 significantly reduced hospitalization risk (OR 0.15; 95%CI: 0.03, 0.73) and improved lung function (26.77% PEFR increase; 95%CI: 18.41, 54.79).
- No significant difference in length of hospital stay was observed between groups.
- Due to heterogeneity, other outcomes were synthesized narratively.
Conclusions:
- IV-MgSO4 shows promise in reducing hospitalization rates and enhancing lung function in pediatric asthma exacerbations.
- Adverse effects associated with IV-MgSO4 were infrequent.
- Further high-quality research is recommended to fully elucidate the efficacy and safety profile of IV-MgSO4 in this population.
Background:
Asthma is the most prevalent chronic disease in children and constitutes a significant healthcare burden. First-line therapy for acute asthma exacerbations is well established. However, secondary treatments, including intravenous magnesium sulfate (IV-MgSO4), remain variable due to scarcity of data on its efficacy and safety.
Objective:
To assess the effectiveness and safety of IV-MgSO4 as a second line of treatment in managing children with asthma exacerbations.
Methods:
We searched five databases from inception until April 2023 on randomized clinical trials of IV-MgSO4 in children with acute asthma exacerbations. The primary outcomes were hospitalization rate and length, and change in the severity score. Secondary outcomes included percentage increase in peak expiratory flow rate (PEFR), hospital re-admission rate, need and length for pediatric intensive care unit (PICU) treatment, and adverse effects. Meta-analysis was performed for three outcomes with estimated odds ratios (ORs) or mean differences (MDs) and 95% confidence intervals (CIs).
Results:
Eleven studies met the final criteria. In comparison to control, administration of IV-MgSO4 was associated with a reduced hospitalization risk (OR 0.15; 95%CI: 0.03, 0.73) in four studies, and improvement of lung function (MD 26.77% PEFR; 95%CI: 18.41, 54.79) in two studies. There were no significant differences in the length of stay between groups. Due to heterogeneity, a narrative synthesis of other outcomes was performed.
Conclusion:
The use of IV-MgSO4 demonstrated a reduction in the hospitalization rate and PEFR improvement in children with asthma exacerbations. Adverse effects were rare. Further well-designed studies are needed to better determine the efficacy and safety profile of IV-MgSO4.
Related Concept Videos
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
01:24Antiasthma Drugs: Methylxanthines
Theophylline is thought to inhibit phosphodiesterase enzymes, increasing intracellular levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). This rise in cAMP and cGMP concentrations stimulates cardiac function,...
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
01:25Antiasthma Drugs: β2-Adrenoceptor Agonists
One class of bronchodilators includes β2-adrenoceptor agonists. These agents target the β2-adrenoceptors located on bronchial smooth muscle cells. By stimulating these receptors, β2-agonists induce...
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.