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Intravenous magnesium sulfate in acute severe asthma not responding to conventional therapy
P R Devi1, L Kumar, S C Singhi
1Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh.
Insights
Early intravenous Magnesium sulfate (i.v. MgSO4) significantly improved respiratory function and clinical symptoms in children with severe asthma unresponsive to standard treatments. This study highlights MgSO4 as a valuable addition to conventional therapy for pediatric acute severe asthma.
Area of Science:
- Pediatric Emergency Medicine
- Respiratory Medicine
- Pharmacology
Background:
- Acute severe asthma in children often requires intensive management.
- Conventional therapies may be insufficient for some pediatric asthma patients.
- Intravenous Magnesium sulfate (i.v. MgSO4) is explored as an adjunct therapy.
Purpose of the Study:
- To assess the efficacy of early i.v. MgSO4 administration.
- To evaluate its impact on children with acute severe asthma.
- To determine effectiveness in patients not responding to conventional treatment.
Main Methods:
- Randomized, double-blind, placebo-controlled trial.
- Involved 47 children (1-12 years) with acute severe asthma.
- Compared i.v. MgSO4 infusion versus normal saline placebo alongside standard care.
Main Results:
- The i.v. MgSO4 group demonstrated significantly earlier improvements in PEFR and SaO2 compared to placebo.
- Clinical asthma scores showed marked improvement in the MgSO4 group.
- Statistical significance (p < 0.05 to < 0.01) was observed at multiple time points.
Conclusions:
- Adding i.v. MgSO4 to conventional therapy accelerates improvement in pediatric acute severe asthma.
- It is effective for patients with inadequate response to standard treatments alone.
- i.v. MgSO4 offers a beneficial therapeutic option for severe pediatric asthma.
Objective:
To evaluate the effectiveness of early administration of intravenous Magnesium sulfate (i.v. MgSO4) in children with acute severe asthma not responding to conventional therapy.
Design:
Randomized double-blind, placebo-controlled trial.
Setting:
Pediatric emergency service of a large teaching hospital.
Subjects:
47 children aged between 1-12 years with acute severe asthma showing inadequate or poor response to 3 doses of nebulized salbutamol given at an interval of 20 min each.
Intervention:
The MgSO4 group received 0.2 ml/kg of 50% MgSO4 as intravenous (i.v.) infusion over 35 minutes and the placebo group received normal saline infusion in the same dose and at the same rate. MgSO4 solution and normal saline were coded and dispensed in identical containers. Decoding was done at the completion of the study. All the patients received oxygen, nebulized salbutamol, i.v. aminophylline and corticosteroids.
Results:
MgSO4 group showed early and significant improvement as compared to placebo group in PEFR and SaO2 at 30 min and 1, 2, 3 and 7 hours after stopping the infusion (p ranging from < 0.05 to < 0.01). The clinical asthma score also showed significant improvement in the MgSO4 group 1, 2, 3 and 11 hours after stopping the infusion (p < 0.01).
Conclusion:
Addition of MgSO4 to conventional therapy helps in achieving earlier improvement in clinical signs and symptoms of asthma and PEFR in patients not responding to conventional therapy alone.