CHAPTER 76 MAGNESIUM IN ASTHMA

Intravenous Magnesium as an Adjuvant in Acute Bronchospasm: A Meta-Analysis

Alter HJ, Koepsell TD, Hilty WM. Ann Emerg Med. 2000;36(3):191–197

BACKGROUND

It is estimated that 5% to 10% of all patients with asthma will present with an acute exacerbation that does not respond to typical bronchodilator therapy. This is a major cause of morbidity and the source of 440,000 annual hospitalizations with an average length of stay of 3.6 days. In vitro studies have shown that magnesium has bronchodilating capacity through smooth muscle relaxation that operates independently of the beta-2 receptor. Studies prior to 2000 showed conflicting results on the benefit of IV magnesium in acute asthma exacerbation. Prior to this meta-analysis little was known about the efficacy of IV Magnesium in the ED treatment of acute asthma and chronic obstructive pulmonary disease (COPD) exacerbations.

OBJECTIVES

To determine whether the addition of IV magnesium bolus to standard therapy improves acute bronchospasm.

METHODS

Meta-analysis of nine clinical trials.

Patients

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