Overview
Acute asthma exacerbations are a significant cause of emergency department visits and hospitalizations, particularly in pediatric populations 1. Despite standard treatments, some exacerbations are refractory and require adjunctive therapies 1.Diagnosis
No information provided in the abstracts.Management
Intravenous magnesium sulfate (IVMg) may be used as an adjunctive treatment for pediatric acute asthma exacerbations 1.
Reductions in Pediatric Respiratory Assessment Measure scores were associated with both total and ionized serum magnesium area under the concentration-time curve in children treated with IVMg 1.
Hypotension is a potential safety concern with IVMg 1.
The 2020 Asthma Guideline Update provides recommendations for adolescents and adults, including intermittent inhaled corticosteroids (ICSs), add-on long-acting muscarinic antagonists, fractional exhaled nitric oxide, indoor allergen mitigation, immunotherapy, and bronchial thermoplasty 2.Special Populations
Pediatric acute asthma exacerbations are a significant cause of emergency department use and hospitalizations 1.
Intravenous magnesium sulfate has been studied in pediatric populations for acute asthma exacerbations 1.Key Recommendations
Intravenous magnesium sulfate may be considered as an adjunctive treatment for pediatric acute asthma exacerbations refractory to standard therapies 1. (Evidence: Moderate)
Monitor for hypotension as a potential safety concern when administering intravenous magnesium sulfate to children with acute asthma exacerbations 1. (Evidence: Moderate)
The 2020 Asthma Guideline Update includes recommendations for managing asthma in adolescents and adults, covering topics such as inhaled corticosteroids, long-acting muscarinic antagonists, and allergen mitigation 2. (Evidence: Expert opinion)References
1 Rower JE, Johnson MD, Zorc JJ, Shihabuddin B, Dai M, Barney BJ et al.. Pharmacokinetics and Pharmacodynamics of Intravenous Magnesium Sulfate in Pediatric Acute Asthma Exacerbations. Journal of clinical pharmacology 2025. link
2 Cloutier MM, Dixon AE, Krishnan JA, Lemanske RF, Pace W, Schatz M. Managing Asthma in Adolescents and Adults: 2020 Asthma Guideline Update From the National Asthma Education and Prevention Program. JAMA 2020. link