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2017 ; 152
(1
): 113-119
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IV Magnesium Sulfate for Bronchiolitis: A Randomized Trial
#MMPMID28286262
Alansari K
; Sayyed R
; Davidson BL
; Al Jawala S
; Ghadier M
Chest
2017[Jul]; 152
(1
): 113-119
PMID28286262
show ga
BACKGROUND: The goal of this study was to determine if IV magnesium, useful for
severe pediatric asthma, reduces time to medical readiness for discharge in
patients with bronchiolitis when added to supportive care. METHODS: We compared a
single dose of 100 mg/kg of IV magnesium sulfate vs placebo for acute
bronchiolitis. Patients received bronchodilator therapy, nebulized hypertonic
saline, and 5 days of dexamethasone if there was eczema and/or a family history
of asthma. Time to medical readiness for discharge was the primary efficacy
outcome. Bronchiolitis severity scores and need for infirmary or hospital
admission and for clinic revisits within 2 weeks were secondary outcomes.
Cardiorespiratory instability onset was the safety outcome. RESULTS: A total of
162 previously healthy infants diagnosed with bronchiolitis aged 22 days to
17.6 months (median, 3.7 months) were enrolled. Approximately one-half of
patients had eczema and/or a family history of asthma; 86.4% had positive
findings on nasopharyngeal virus swabs. Geometric mean time until medical
readiness for discharge was 24.1 h (95% CI, 20.0-29.1) for the 78
magnesium-treated patients and 25.3 h (95% CI, 20.3-31.5) for the 82 patients
receiving placebo (ratio, 0.95 [95% CI, 0.52-1.80]; P = .91). Mean bronchiolitis
severity scores over time were similar for the two groups. The frequency of
clinic visits in the subsequent 2 weeks (33.8% and 27.2%, respectively) was also
similar. Fifteen magnesium recipients (19.5%) vs five placebo recipients (6.2%)
were readmitted to the infirmary or hospital within 2 weeks (P = .016). No acute
cardiorespiratory side effects were reported. CONCLUSIONS: IV magnesium did not
provide benefit for patients with acute bronchiolitis and may be harmful. TRIAL
REGISTRY: ClinicalTrials.gov; No.: NCT02145520; URL: www.clinicaltrials.gov.
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