Efficacy of Magnesium Sulfate Treatment in Children with Acute Asthma

Abstract

Objective: Systemic administration of magnesium sulfate (MgSO₄) has been proposed as a treatment for pediatric patients with acute asthma. However, previous trials show mixed results and uncertain evidence of benefit. The aim of the study was to ascertain whether intravenous (IV) MgSO₄ improves lung function parameters in children with acute asthma. Methods: This was a prospective clinical trial. All patients with acute asthma received 40–50 mg/kg or maximum 1,500 mg (>30 kg) of single dose IV MgSO₄, administered over 60 min. Spirometry was conducted before and 15 min after MgSO₄ infusion. Results: One hundred and fifteen children aged 6 to 17 years presenting with acute asthma and FEV₁ between 40% and 75% of predicted were included. Then, the patients were classified into 2 groups; mild asthma attack (FEV₁ ranged from 60% to 75%; n = 50) or moderate asthma attack (FEV₁ ranged from 40% to 59%; n = 65). The baseline characteristics were similar in both groups. The mean percent predicted pre and post values for FEV₁/FVC ratio (mild group: 82.59 ± 9.46 vs. 85.06 ± 8.95; moderate group: 77.31 ± 11.17 vs. 79.99 ± 11.77), FEV₁ (mild group: 67.14 ± 4.99 vs. 72.29 ± 8.05; moderate group: 48.50 ± 6.81 vs. 53.78 ± 9.81), PEF (mild group: 65.49 ± 12.32 vs. 71.37 ± 12.96; moderate group: 47.56 ± 11.78 vs. 51.97 ± 13.98), and FEF_25–75 (mild group: 58.20 ± 12.24 vs. 66.57 ± 16.95; moderate group: 37.77 ± 11.37 vs. 43.41 ± 14.19) showed a statistically significant (p < 0.05 for all) bronchodilator effect after MgSO₄ infusion in both groups with few side effects. Conclusion: Administration of IV MgSO₄ was associated with improved pulmonary function in children with acute asthma.