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magnesium nebulization pediatric

Zhantao Su, Rui Li, Zhongtao Gai
OBJECTIVE: This study aimed to evaluate the efficacy of intravenous (IV) and nebulized magnesium sulfate in acute asthma in children. METHODS: The PubMed, Cochrane Library, and EMBASE databases were searched. Randomized controlled trials and quasi-randomized controlled trials of IV and nebulized magnesium sulfate in pediatric acute asthma were included. The outcomes subject to meta-analysis were pulmonary function, hospitalization, and further treatment. If statistical heterogeneity was significant, random-effects models were used for meta-analysis, otherwise, fixed-effects models were applied...
October 4, 2016: Pediatric Emergency Care
Suzanne Schuh, Judy Sweeney, Stephen B Freedman, Allan L Coates, David W Johnson, Graham Thompson, Jocelyn Gravel, Francine M Ducharme, Roger Zemek, Amy C Plint, Darcy Beer, Terry Klassen, Sarah Curtis, Karen Black, Darcy Nicksy, Andrew R Willan
BACKGROUND: Up to 30 % of children with acute asthma are refractory to initial therapy, and 84 % of this subpopulation needs hospitalization. Finding safe, noninvasive, and effective strategies to treat this high-risk group would substantially decrease hospitalizations, healthcare costs, and the psycho-social burden of the disease. Whereas intravenous magnesium (Mg) is effective in severe refractory asthma, its use is sporadic due to safety concerns, with the main treatment goal being to prevent intensive care unit admission...
May 24, 2016: Trials
Xiaoxi Liu, Tian Yu, Joseph E Rower, Sarah C Campbell, Catherine M T Sherwin, Michael D Johnson
BACKGROUND: Asthma is the most common pediatric chronic disease and currently affects 7.1 million children in the United States. Many children experience acute asthma exacerbations. Many children also require hospitalization despite treatment in an emergency department with current standard therapy (corticosteroids, albuterol, and ipratropium). These hospitalizations may be avoided if effective adjunctive therapies can be developed to adequately treat severe exacerbations. METHODS: Publications were searched in the PubMed database using the following keywords: magnesium AND asthma AND children AND randomized controlled trial...
May 24, 2016: Pediatric Pulmonology
Khalid Alansari, Wessam Ahmed, Bruce L Davidson, Mohamed Alamri, Ibrahim Zakaria, Mahomud Alrifaai
BACKGROUND: Intravenous magnesium sulfate, a rescue therapy added to bronchodilator and systemic steroid therapy for moderate and severe asthma, is uncommonly administered. We hypothesized that nebulized magnesium would confer benefit without undue risk. DESIGN AND METHODS: Patients aged 2 to 14 y with moderate and severe asthma (PRAM severity score ≥ 4) admitted to infirmary/observation unit care were randomized double-blind on admission to receive 800 mg nebulized magnesium or normal saline placebo after all received intensive therapy with combined nebulized albuterol-ipratropium and intravenous methylprednisolone...
December 2015: Pediatric Pulmonology
Mehmet Kose, Mehmet Adnan Ozturk, Hakan Poyrazoğlu, Tuba Elmas, Duygu Ekinci, Filiz Tubas, Tuba Kurt, Mehmet Akif Goktas
UNLABELLED: The aim of this paper is to compare the effect of nebulized magnesium sulfate to nebulized salbutamol and salbutamol/magnesium sulfate on successful discharge from the emergency department. A total of 56 infants were included in this double-blinded, prospective study. Infants were grouped according to the nebulized treatment they received: group 1-salbutamol/normal saline, group 2-magnesium sulfate and normal saline, and group 3-salbutamol plus magnesium sulfate. Heart beat, bronchiolitis, clinical severity scores (CSS), and oxygen saturation of the patients were determined before and after nebulization (0, 1, 4 h)...
September 2014: European Journal of Pediatrics
Alexander Wade, Christopher Chang
The heterogeneity of asthma is illustrated by the significantly different features of pediatric asthma compared to adult asthma. One phenotype of severe asthma in pediatrics includes atopy, lack of reduction in lung function, and absence of gender bias as the main characteristics. Included in the NIH NAEPP EPR-3 are recommendations for the treatment and management of severe pediatric asthma and critical asthma syndrome, such as continuous nebulization treatments, intubation and mechanical ventilation, heliox, and magnesium sulfate...
February 2015: Clinical Reviews in Allergy & Immunology
Allan L Coates, Kitty Leung, Laurent Vecellio, Suzanne Schuh
BACKGROUND: As the use of intravenous magnesium sulfate (MgSO(4)) for the treatment of refractory asthma is becoming more common, the incidence of MgSO(4)-related systemic hypotension is also rising. One option is to deliver MgSO(4) via aerosol, but compared to most inhaled medications, which are active in the microgram dose range, the MgSO(4) dose requirement is in the milligram range. This, along with inefficient aerosol delivery systems, may be the reason that some studies have found lack of efficacy with aerosol MgSO(4)...
March 2011: Respiratory Care
Marcela Davalos Bichara, Ran D Goldman
QUESTION: Magnesium is considered adjuvant therapy for moderate to severe asthma exacerbations in adults, but can it be used to treat children? ANSWER: Magnesium seems to be beneficial in the treatment of moderate to severe asthma in children. It is a safe drug to administer, but there have been minor side effects reported, such as epigastric or facial warmth, flushing, pain and numbness at the infusion site, dry mouth, malaise, and hypotension. Owing to its bronchodilating and anti-inflammatory effects, magnesium is an encouraging adjuvant therapy for pediatric patients who do not respond to conventional treatment in acute severe exacerbations...
September 2009: Canadian Family Physician Médecin de Famille Canadien
Kelly Keefe Marcoux
Status asthmaticus (SA) in the pediatric ICU (PICU) can progress to a life-threatening emergency. The goal of management is to improve hypoxemia, improve bronchoconstriction, and decrease airway edema through the administration of continuous nebulized beta2 adrenergic agonist with intermittent anticholinergics, corticosteroids, and oxygen. Adjunctive therapies, such as magnesium, methylxanthines, intravenous beta-agonists, heliox, and noninvasive ventilation should be considered in the child who fails to respond to initial therapies...
December 2005: Critical Care Nursing Clinics of North America
J C Santana, S S Barreto, J P Piva, P C Garcia
OBJECTIVE: To study the efficacy of intravenous magnesium sulfate and intravenous salbutamol in the treatment of severe asthma in children. METHODS: Randomized, double-blind, placebo-controlled clinical trial, including children above 2 years of age with severe acute asthma admitted to the observation ward of the Pediatric Intensive Care Unit of Hospital São Lucas. All patients received conventional treatment (oxygen, corticoids, beta-adrenergics) on admission, and later received one of the following solutions: a) IVMg (50 mg/kg); b) intravenous salbutamol (1 micro g/kg); c) saline solution...
July 2001: Jornal de Pediatria
Krishan Chugh
Acute asthmatic exacerbation is one of the commonest emergencies seen in the pediatric age group. Viral infections are the most important triggers which set up the inflammatory reaction in the bronchial mucosa. GINA 2002 guidelines for assessing the severity and management are very useful for day to day practice. There is evidence to support the view that metered dose inhaler alongwith spaceor with or without mask is as effective as the standard doses of beta-2 agonists given by nebulizer. Ipratrpium bromide adds to the benefits of short acting beta-2 agonists...
March 2003: Indian Journal of Pediatrics
Mark L Glover, Cary Machado, Balagangadhar R Totapally
PURPOSE: To evaluate the dosing and safety of intravenous magnesium sulfate administered via continuous infusion for refractory wheezing. MATERIALS AND METHODS: All patients admitted to the pediatric intensive care unit (PICU) between January 1998 and March 2001 who were prescribed magnesium sulfate via continuous infusion were identified via retrospective chart review. The patient's medical history, demographic data, vital signs, magnesium dosing history, and concurrent medications were recorded...
December 2002: Journal of Critical Care
E L'her
Experts designated by the "référentiels" committee of the SRLF analyzed the numerous articles published after the French consensus conference on the severe acute asthma of 1988. From their work, a revision of this consensus conference has been performed. The pediatric specificity has been added in this revision. There is no severity score able to predict the severity of acute asthma on admission. In every case, the nebulization of beta-2 agonists represents the priority treatment. The nebulization of anticholinergic associated with the beta-2 agonists induces a moderate additional effect...
October 2002: Revue des Maladies Respiratoires
Benjamin Volovitz, Moshe Nussinovitch
Although acute asthma is a very common cause of emergency department visits in children, there is as yet insufficient evidence for the establishment of a standardized treatment protocol. The aim of this review is to describe updated information on the management of asthma exacerbations in the pediatric emergency department. Oxygen is the first-line treatment of acute asthma exacerbations in the emergency department to control hypoxemia. It is accompanied by the administration of beta(2)-adrenoceptor agonists followed by corticosteroids...
2002: Paediatric Drugs
J M García Martínez
Morbidity and mortality derived from asthma continue to be a main public health problem in many countries, in spite of the advances in the knowledge on the disease and its treatment. There are several risk factors for asthma attack which have to be considered in the management of patients in order to prevent exacerbations and mortality. Smooth bronchial muscle constriction and inflammation with oedema of the bronchial wall are the facts that cause airway flow and resistance disturbances, with hyperinflation, leading to a bigger respiratory work...
March 1999: Allergologia et Immunopathologia
P R Devi, L Kumar, S C Singhi, R Prasad, M Singh
OBJECTIVE: To evaluate the effectiveness of early administration of intravenous Magnesium sulfate (i.v. MgSO4) in children with acute severe asthma not responding to conventional therapy. DESIGN: Randomized double-blind, placebo-controlled trial. SETTING: Pediatric emergency service of a large teaching hospital. SUBJECTS: 47 children aged between 1-12 years with acute severe asthma showing inadequate or poor response to 3 doses of nebulized salbutamol given at an interval of 20 min each...
May 1997: Indian Pediatrics
L Ciarallo, A H Sauer, M W Shannon
OBJECTIVE: To evaluate the efficacy of intravenous magnesium (IVMg) therapy for moderate to severe asthma exacerbations in pediatric patients. DESIGN: Randomized, double-blind, placebo-controlled, clinical trial. SETTING: Urban pediatric emergency department. PARTICIPANTS: Thirty-one patients aged 6 to 18 years who were being treated for an acute asthma exacerbation with peak expiratory flow rate (PEFR) less than 60% of the predicted value after receiving three beta 2-adrenergic nebulizer treatments...
December 1996: Journal of Pediatrics
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