Intravenous magnesium sulphate in children with acute wheeze: a nationwide survey

Abstract

Objective

Dutch guidelines recommend to consider intravenous magnesium sulfate (iv MgSO₄) as a treatment option in case of failure of first line treatment in both children with exacerbations of acute episodic viral wheeze (AEVW) and acute asthma (AA). The implications on the actual use of iv MgSO₄ iv in daily practice in both groups are unknown. Therefore, we conducted a cross-sectional nationwide survey to evaluate the use of iv MgSO₄ in children with AEVW and AA.

Methods

A questionnaire was handed out to pediatricians and pediatric residents in one academic and six community teaching hospitals.

Results

In 111 respondents, 76% reported regular use of iv MgSO₄ in children with AEVW and 96% in children with AA. In total 89% and 93% of users were convinced iv MgSO₄ was effective in children with AEVW and AA, respectively. Adverse effects, mainly hypotension, were identified by 23% and 17% of users in AEVW and AA, respectively. Most common reasons not to give MgSO₄ were lack of evidence and small amount of studies.

Conclusions

IV MgSO₄ is reported to be widely used in Dutch practice in both young children with AEVW and older children with AA by respondents, while the national guidelines advise only to consider this treatment option.

Keywords:

• Acute asthma
• acute episodic viral wheeze
• children
• magnesium sulfate
• exacerbation
• asthma exacerbation

Acknowledgements

We would like to thank the pediatricians and pediatric residents who participated in this study. We would also like to thank JG van Genderen and L Bakvis OLVG Amsterdam, MC Bierlaagh Noordwest Ziekenhuisgroep Alkmaar, M Merelle and TT Paff Spaarne Gasthuis Haarlem, M Bel Isala Zwolle, W Balemans Antonius Nieuwegein, for their help in the distribution and collection of the questionnaires.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.