DOES INTRAVENOUS MAGNESIUM REDUCE HOSPITAL ADMISSION RATES IN ADULTS WITH SEVERE ACUTE ASTHMA?
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Date
2015-04
Authors
Hall, Steven
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Abstract
Introduction: Asthma is a chronic respiratory disease characterized by bronchial hyper-responsiveness, airflow
obstruction, and inflammation that presents with symptoms of cough, dyspnea, chest tightness, wheezing, and
sputum production. Symptoms of asthma can range from mild to severe, resulting in hospitalization, intubation,
and even death. In addition to inhaled beta agonists, nebulized ipratropium, oxygen, and systemic
corticosteroids, magnesium sulfate has been used as an adjunctive treatment of acute severe asthma
exacerbations. However, despite its use, its effectiveness has been inconclusive and controversial, with
previous studies showing the greatest benefit in those having severe exacerbations. This literature review was
conducted to determine if magnesium sulfate administration reduces hospital admission rates in adults with
acute, severe exacerbations.
Methods: A literature search was conducted for research studies of adult patients who presented with an acute,
severe asthma exacerbation and were treated with intravenous magnesium sulfate. Study dates were limited to
the years 1989-2014, and were identified through PubMed, Scopus, Embase, and Google Scholar, with further
studies identified through the search of reference lists of published articles. A total of 11 studies were found
using the sources above. Of these 11 studies, 5 double blind, randomized, placebo controlled trials were selected
for this review.
Results: Results from the five randomized controlled trials selected were mixed, with two studies showing a
decrease in admissions (one had weak evidence of a decrease), and three studies showing no difference in
admission rates.
Conclusion: Intravenous magnesium sulfate does not appear to decrease admission rates in adult asthmatics
having a severe exacerbation.
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Keywords
asthma, intravenous magnesium