Intravenous magnesium sulfate rapidly and safely calms severe asthma attacks unresponsive to initial treatments in children, significantly outperforming the risks of aminophylline in a head-to-head trial.
A recent randomized trial published in Andes Pediatrica found that intravenous magnesium sulfate (MgSO4) at a dose of 50mg/kg led to greater improvement in symptoms compared to intravenous aminophylline for children with acute severe asthma failing initial emergency room treatment.1
The study divided 131 children into two groups – one receiving a single 50mg/kg dose of MgSO4 and one receiving a 5mg/kg loading dose of aminophylline followed by a 1mg/kg/hour infusion for 3 hours. The MgSO4 group showed significantly greater improvement in clinical asthma severity scores and oxygen saturation levels. They also had a 68% lower relative risk of hospital admission and 84% lower risk of needing additional rescue medications compared to the aminophylline group.2
MgSO4, the form of magnesium found in Epsom salt known as magnesium sulfate, was well tolerated with only one transient side effect reported, compared to more concerning risks with aminophylline including cardiac arrhythmias and seizures.3,4 The authors concluded MgSO4 is a safer and more effective add-on treatment for severe pediatric asthma attacks not responding to initial inhaled bronchodilators and corticosteroids.
The mineral magnesium is essential for over 300 bodily processes and naturally assists proper lung function. Intravenous MgSO4 is inexpensive, readily available in most hospitals, and simple to administer. This study provides evidence it could replace riskier drugs like aminophylline for severe asthma flare-ups in children.
More research is still needed to confirm optimal MgSO4 dosing protocols. But these findings suggest readily supplementing magnesium levels during acute asthma crises may significantly benefit outcomes for the most severely afflicted young patients.
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References:
Kassisse E, Jiménez J, Mayo N, Kassisse J. Magnesium sulfate vs aminophylline as a second line of treatment in children with severe acute asthma. Randomized clinical trial. Andes pediatr. 2021;92(3):367-374. doi:10.32641/andespediatr.v92i3.2969
Kassisse et al. 2021
Reed 2010
Yung & Mikus 1988