The effect of nebulized magnesium sulfate on the treatment of acute asthma

Abstract

Most previous studies have shown a significant bronchodilating effect of intravenous magnesium sulfate (MgSO4) in the treatment of acute severe asthma. However, the role of inhaled MgSO4 in such cases is less well defined. In this randomized, double-blind, placebo-controlled trial, 52 individuals with acute, severe asthma exacerbations were treated by nebulization with either 2.5 ml of isotonic MgSO4 or isotonic saline solution on 3 occasions at 30-minute intervals. Other treatments, including nebulized albuterol, were given to all subjects through use of a standard protocol. After this 90-minute treatment period, the FEV1 was significantly greater after MgSO4 treatment than after saline treatment (mean, 1.96 vs 1.55 L; P = .003). The authors conclude that the use of isotonic magnesium as an adjuvant to nebulized albuterol results in an enhanced bronchodilator response in the treatment of severe asthma. However, it is unclear from their findings whether the frequency of in-patient admissions would be decreased significantly in those treated with nebulized MgSO4. In addition, other studies have concluded that MgSO4 treatment does not significantly enhance the rate or degree of improvement in the therapy of mild to moderate asthma flares.