Use of intravenous magnesium sulfate for the treatment of an acute asthma exacerbation in pediatric patients

Abstract

Objectives: The standard of care for treatment of an asthma exacerbation includes oxygen, inhaled short-acting bronchodilators, and systemic corticosteroids; adjunctive therapies, such as intravenous magnesium sulfate, can be used for patients who are having life-threatening exacerbations. The purpose of this study was to analyze the prescribing patterns as well as the safety of intravenous magnesium sulfate for the treatment of acute asthma exacerbations in pediatric patients across multiple hospitals in New Jersey.

Methods: This retrospective chart review was conducted at 4 medical centers in New Jersey on patients who presented to the emergency department between January 1, 2010, and December 31, 2010.

Results: Fifty-three patients were included in the study. In the emergency department, 98% of patients received inhaled albuterol plus ipratropium and 85% received systemic corticosteroids before intravenous magnesium sulfate administration. The median dose of magnesium sulfate was 40 mg/kg with a median time of administration of 20 minutes. One patient experienced hypotension that was thought to be related to magnesium sulfate administration.

Conclusions: This study demonstrates that weight-based dosage, as well as time of administration of magnesium sulfate for pediatric patients with an acute asthma exacerbation, varies across different institutions in New Jersey. Magnesium sulfate use was safe in this patient population.

Keywords: asthma; children; magnesium; pediatric.

Figures

Figure 1.

Emergency department management. Medical Center A (N = 15); Medical Center B (N = 3); Medical Center C (N = 31); Medical Center D (N = 4)

Figure 2.

Primary and secondary outcomes. Hospital A; Hospital B; Hospital C; Hospital D; Total Abbreviation: PICU, pediatric intensive care unit