The effect of nebulised magnesium sulphate in the management of childhood moderate asthma exacerbations as adjuvant treatment

Background: After the bronchodilator effect of magnesium was shown, the use of magnesium in treatment of asthma exacerbations became common. With the results of recent studies, the use of intravenous magnesium in severe asthma exacerbations took its place. We aimed to examine the effects of adding isotonic magnesium sulphate instead of isotonic saline into nebulised salbutamol on the Modified Pulmonary Index Score (MPIS) and the hospitalisation rate in moderate asthma exacerbations. Methods: Our study population included 100 children age between 3 and 15 years with asthma admitted to emergency department due to moderate asthma exacerbations. The patients were randomised to placebo or magnesium, with 50 patients in each arm. All patients received 1 mg/kg of systemic methylprednisolone at the beginning of treatment and thereafter received either nebulised salbutamol (0.15 mg/kg/dose) and 1 ml magnesium sulphate (15%) + 1.5 ml isotonic saline on three occasions at roughly 20 min intervals (Magnesium group) or nebulised salbutamol (0.15 mg/kg/dose) and 2.5 ml isotonic saline mixture on three occasions at roughly 20 min intervals (Placebo group). The MPIS of patients on 0th min, 20th min, 40th and 120th min were calculated and compared. The primary outcome was to compare MPIS values at the end of 120th min. Results: Both groups have similar demographic, allergic characteristics and baseline MPIS scores. When the MPIS scores in the 120th min and admission rates in the 200th min, there was no significant difference between the two groups. Conclusions: The use of nebulised magnesium sulphate in moderate asthma exacerbation as adjuvant treatment showed no benefit to standard treatment in our study. (C) 2016 SEICAR Published by Elsevier Espana, S.L.U. All rights reserved.