Rapid infusion of magnesium sulfate obviates need for intubation in status asthmaticus

Abstract

Rapid infusion of intravenous magnesium sulfate (MgSO 4) was given to two young adults with impending respiratory failure caused by status asthmaticus. The infusion of 2 g of MgSO 4 during a 2-minute period was associated with an immediate, dramatic reversal of their severe bronchospasm. This treatment obviated the need for intubation. Continuous β 2-agonist therapy was performed simultaneously, taking advantage of the MgSO 4-induced bronchodilation to deliver the β 2-agonist to the target tissues. Rapid infusion of intravenous MgSO 4 has been documented as safe in standard obstetric literature. Previous reports of MgSO 4 therapy for acute asthma have used slow infusion. This is the first report of rapid infusion of MgSO 4 for the emergency department management of asthma. In both cases, this therapy obviated the need for endotracheal intubation and mechanical ventilation.