https://doi.org/10.4081/monaldi.2023.2664
Clinical outcomes of children with acute asthma managed with intravenous magnesium sulfate outside intensive care setting
Submitted: June 14, 2023
Accepted: August 28, 2023
Published: September 12, 2023
Accepted: August 28, 2023
Abstract Views: 1542
PDF: 123
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Asthma in children constitutes a well-known respiratory condition with significant mortality. In poorly controlled asthma, multiple adjunct therapies, including magnesium sulfate (MS), are recommended to decrease the likelihood of intubation; however, limited evidence exists to support their routine usage in day-to-day situations. The aim of this study is to determine the outcomes of pediatric patients treated with MS during exacerbations of asthma admitted at a tertiary care unit. A retrospective study was conducted at the Aga Khan University Hospital, Karachi, Pakistan, from January 2019 to December 2021. Patients aged 6 years to 15 years who presented with acute asthma through the emergency room, having a clinical respiratory score of more than 5, and were admitted to the high-dependency unit (HDU) were included in the study. Patients who were started on MS within 24 hours of admission were categorized in the MS group. Patients receiving all standard acute asthma treatment but were not started on magnesium therapy within 24 hours of admission were categorized in the non-MS group. Different outcome variables were compared between the groups. A total of 110 patients with asthma were enrolled. A total of 54 patients were categorized into the MS group, while 56 were included in the non-MS group. Fewer patients were transferred from HDU to the pediatric intensive care unit (PICU) (24.07%) in the MS group compared to the non-MS group (42.85%), (p=0.02). In the MS group, the mean number of days spent on oxygen in HDU was 2.38±0.81, while the non-MS group spent more days (3.10±0.84) (p<0.01). This study demonstrates that for pediatric patients with severe asthma exacerbations, administration of intravenous MS (within 24 hours) is beneficial, results in fewer admissions to PICU, and reduces the mean number of days spent on oxygen therapy.
Song P, Adeloye D, Salim H, et al. Global, regional, and national prevalence of asthma in 2019: a systematic analysis and modelling study. J Glob Health 2022;12:04052.
Khan MA. Monthly and seasonal prevalence of asthma and chronic obstructive pulmonary disease in the District Dera Ismail Khan, Khyber Pakhtunkhwa, Pakistan. Egypt J Bronchol 2022;16:63.
Singh S, Salvi S, Mangal DK, et al. Prevalence, time trends and treatment practices of asthma in India: the Global Asthma Network study. ERJ Open Res 2022;8:00528-2021.
Oland AA, Booster GD, Bender BG. Psychological and lifestyle risk factors for asthma exacerbations and morbidity in children. World Allergy Organ J 2017;10:35.
Sullivan PW, Ghushchyan VH, Campbell JD, et al. Measuring the cost of poor asthma control and exacerbations. J Asthma 2017;54:24-31.
Castillo JR, Peters SP, Busse WW. Asthma exacerbations: pathogenesis, prevention, and treatment. J Allergy Clin Immunol Pract 2017;5:918-27.
Craig VL, Bigos D, Brilli RJ. Efficacy and safety of continuous albuterol nebulization in children with severe status asthmaticus. Pediatr Emerg Care 1996;12:1-5.
National Asthma Education and Prevention Program, Third Expert Panel on the Diagnosis and Management of Asthma. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Section 5, Managing Exacerbations of Asthma. Bethesda: National Heart, Lung, and Blood Institute (US); 2007. Available from: https://www.ncbi.nlm.nih.gov/books/NBK7228/
Cheuk DK, Chau TC, Lee SL. A meta-analysis on intravenous magnesium sulphate for treating acute asthma. Arch Dis Child 2005;90:74-7.
Cairns CB, Kraft M. Magnesium attenuates the neutrophil respiratory burst in adult asthmatic patients. Acad Emerg Med 1996;3:1093-7.
Nayani K, Naeem R, Munir O, et al. The clinical respiratory score predicts paediatric critical care disposition in children with respiratory distress presenting to the emergency department. BMC Pediatr 2018;18:339.
Liu X, Yu T, Rower JE, et al. Optimizing the use of intravenous magnesium sulfate for acute asthma treatment in children. Pediatr Pulmonol 2016;51:1414-21.
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2022. Available from: https://ginasthma.org/gina-reports/
Rothe T, Spagnolo P, Bridevaux PO, et al. Diagnosis and management of asthma - the Swiss Guidelines. Respiration 2018;95:364-80.
Forno E, Celedón JC. Predicting asthma exacerbations in children. Curr Opin Pulm Med 2012;18:63-9.
Griffiths B, Kew KM. Intravenous magnesium sulfate for treating children with acute asthma in the emergency department. Cochrane Database Syst Rev 2016;4:CD011050.
Song WJ, Chang YS. Magnesium sulfate for acute asthma in adults: a systematic literature review. Asia Pac Allergy 2012;2:76-85.
DeLaroche AM, Mowbray FI, Bohsaghcheghazel M, et al. Early versus delayed administration of intravenous magnesium sulfate for pediatric asthma. Am J Emerg Med 2021;50:36-40.
Johnson PN, Drury AS, Gupta N. Continuous magnesium sulfate infusions for status asthmaticus in children: a systematic review. Front Pediatr 2022;10:853574.
Gross Júnior M, Lago PM, Santana JCB, et al. Use of magnesium sulfate in continuous infusion in patients with severe acute asthma, in a pediatric emergency room. Pediatr Pulmonol 2021;56:1924-30.
Irazuzta JE, Chiriboga N. Magnesium sulfate infusion for acute asthma in the emergency department. J Pediatr (Rio J) 2017;93:S19-25.
Bidwell J. IV magnesium sulfate for treating children with acute asthma in the ED. Am J Nurs 2017;117:59.
Forster BL, Thomas F, Arnold SR, Snider MA. Early intravenous magnesium sulfate administration in the emergency department for severe asthma exacerbations. Pediatr Emerg Care 2023;39:524-9.
Schuh S, Freedman SB, Zemek R, et al. Association between intravenous magnesium therapy in the emergency department and subsequent hospitalization among pediatric patients with refractory acute asthma: secondary analysis of a randomized clinical trial. JAMA Netw Open 2021;4:e2117542.
Bloch H, Silverman R, Mancherje N, et al. Intravenous magnesium sulfate as an adjunct in the treatment of acute asthma. Chest 1995;107:1576-81.
Baudin F, Buisson A, Vanel B, et al. Nasal high flow in management of children with status asthmaticus: a retrospective observational study. Ann Intensive Care 2017;7:55.
Okayama H, Aikawa T, Okayama M, et al. Bronchodilating effect of intravenous magnesium sulfate in bronchial asthma. JAMA 1987;257:1076-8.
Johnson MD, Zorc JJ, Nelson DS, et al. Intravenous magnesium in asthma pharmacotherapy: variability in use in the PECARN Registry. J Pediatr 2020;220:165-74.e2.
Reference.medscape.com. Magnesium sulfate (Rx). Available from: https://reference.medscape.com/drug/mgso4-magnesium-sulfate-344444#4
Hicks MA, Tyagi A. Magnesium sulfate. In: StatPearls. Treasure Island: StatPearls; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554553/
Ethics Approval
Approval was received by the Ethics Review Committee at Aga Khan University Hospital with protocol number ERC: 6228-18471.How to Cite
Aziz, Danish Abdul, Muhammad Aqib Sajjad, and Haissan Iftikhar. 2023. “Clinical Outcomes of Children With Acute Asthma Managed With Intravenous Magnesium Sulfate Outside Intensive Care Setting”. Monaldi Archives for Chest Disease 94 (3). https://doi.org/10.4081/monaldi.2023.2664.
Copyright (c) 2023 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Letizia da Vico, Maddalena Ciompi, Francesca Schininà , Elena Sogaro, Weruska Mannelli, Sandro Cortini, Multidisciplinary team in cardiac rehabilitation and secondary prevention, from the assessment to the education: an educational project , Monaldi Archives for Chest Disease: Vol. 82 No. 1 (2014): Cardiac series
- Cesare Greco, Rivaroxaban in non valvular atrial fibrillation: subgroups analysis , Monaldi Archives for Chest Disease: Vol. 82 No. 1 (2014): Cardiac series
- Marika Werren, Roberto Copetti, Nicola Gaibazzi, Franco Giada, Andrea Faggiano, Chiara Ricci, Pompilio Faggiano, Choosing wisely in cardiology: Five proposals from the Italian Association for Cardiovascular Prevention and Rehabilitation , Monaldi Archives for Chest Disease: Vol. 89 No. 2 (2019)
- Irappa Madabhavi, Malay Sarkar, Nagaveni Kadakol, COVID-19: a review , Monaldi Archives for Chest Disease: Vol. 90 No. 2 (2020)
- Shekhar Kunal, Kashish Gupta, Shashi Mohan Sharma, Vijay Pathak, Shruti Mittal, Chandrakant Tarke, Cardiovascular system and COVID-19: perspectives from a developing country , Monaldi Archives for Chest Disease: Vol. 90 No. 2 (2020)
- Olga Vriz, Andrea Rossi Zadra, Abdalla Eltayeb , Fatima Asiri, Claudio Pragliola, Nader Fawzy, Domenico Galzerano, Khalid Feras, Zohair Alhalees, Abdulhalim J. Kinsara, Fadl Elmula Mohamed Fadl Elmula, Loss of engagement in controlling chronic anticoagulation therapy during Covid-19 stringency measures. A single center experience of disproportioned increase of stuck mechanical valves , Monaldi Archives for Chest Disease: Vol. 92 No. 2 (2022)
- Kevin John, Ajay Kumar Mishra, Jemimah Nayar, Jordy Mehawej, Amos Lal, Coronavirus disease 2019 and mechanical circulatory support devices: a comprehensive review , Monaldi Archives for Chest Disease: Vol. 93 No. 2 (2023)
- Ruby Joseph, Kavitha Venkatnarayan, Ashitha Nanaiah, Priya Ramachandran, A case of hoarseness of voice following COVID-19 infection , Monaldi Archives for Chest Disease: Vol. 93 No. 4 (2023)
- Fortuna Lubrano, Ilaria Fucile, Maurizio Conte, Ciro Santoro, Francesco Rozza, Nicola De Luca, Costantino Mancusi, Adherence to Mediterranean diet among patients with acute cardiovascular events admitted in Cardiac Rehabilitation unit , Monaldi Archives for Chest Disease: Vol. 93 No. 3 (2023)
- Michele Vitacca, Marta Lazzeri, Enrico Guffanti, Pamela Frigerio, Francesco D’Abrosca, Silvia Gianola, Mauro Carone, Mara Paneroni, Piero Ceriana, Franco Pasqua, Paolo Banfi, Francesco Gigliotti, Carla Simonelli, Serena Cirio, Veronica Rossi, Chiara G. Beccaluva, Mariangela Retucci, Martina Santambrogio, Andrea Lanza, Francesca Gallo, Alessia Fumagalli, Marco Mantero, Greta Castellini, Mariaconsiglia Calabrese, Giorgio Castellana, Eleonora Volpato, Marina Ciriello, Marina Garofano, Enrico Clini, Nicolino Ambrosino, on behalf of AIPO, ARIR, SIP, AIFI and SIFIR, An Italian consensus on pulmonary rehabilitation in COVID-19 patients recovering from acute respiratory failure: results of a Delphi process , Monaldi Archives for Chest Disease: Vol. 90 No. 2 (2020)
<< < 28 29 30 31 32 33 34 35 36 37 > >>
You may also start an advanced similarity search for this article.
