Higher-dose intravenous magnesium therapy for children with moderate to severe acute asthma

Arch Pediatr Adolesc Med. 2000 Oct;154(10):979-83. doi: 10.1001/archpedi.154.10.979.


Objective: To evaluate the efficacy of a 40-mg/kg dose of intravenous magnesium sulfate for moderate to severe asthma exacerbations in pediatric patients.

Study design: Double-blind placebo-controlled trial.

Setting: Two urban tertiary care pediatric emergency departments.

Subjects: Thirty patients, aged 6 to 17.9 years, being treated for an acute asthma exacerbation.

Intervention: Eligible patients received either a magnesium sulfate infusion of 40 mg/kg or saline solution.

Results: At 20 minutes, the time at which the infusion was completed, the magnesium group had a significantly greater percentage of absolute improvement from baseline in each of the following: predicted peak expiratory flow rate (8.6% vs 0.3%, P<. 001), forced expiratory volume in 1 second (7.0% vs 0.2%,P<.001), and forced vital capacity (7.3% vs -0.7%, P<.001). The improvement was greater at 110 minutes: peak expiratory flow rate (25.8% vs 1.9%, P<.001), forced expiratory volume in 1 second (24.1% vs 2.3%; P<. 001), and forced vital capacity (27.3% vs 2.6%, P<.001). Patients who received intravenous magnesium were more likely to be discharged to their homes than those who received the placebo (8/16 vs 0/14; P=. 002).

Conclusion: Children treated with 40 mg/kg of intravenous magnesium sulfate for moderate to severe asthma showed remarkable improvement in short-term pulmonary function.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Asthma / classification
  • Asthma / diagnosis
  • Asthma / drug therapy*
  • Asthma / physiopathology
  • Calcium Channel Blockers / administration & dosage*
  • Calcium Channel Blockers / pharmacology
  • Child
  • Double-Blind Method
  • Emergency Treatment / methods*
  • Female
  • Follow-Up Studies
  • Forced Expiratory Volume / drug effects
  • Humans
  • Infusions, Intravenous
  • Magnesium Sulfate / administration & dosage*
  • Magnesium Sulfate / pharmacology
  • Male
  • Peak Expiratory Flow Rate / drug effects
  • Severity of Illness Index*
  • Time Factors
  • Vital Capacity / drug effects


  • Calcium Channel Blockers
  • Magnesium Sulfate