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Magnesium Sulfate

Dose:

  • Magnesium (IV)
    • 50 mg/kg (maximum 2 grams)

Key Result:
A strong recommendation is made to consider magnesium sulfate (IV) for the patient with a severe asthma exacerbation, or an exacerbation that does not respond to initial treatment in the ED. The effect is well studied in adults and is graded as high-quality evidence. In adults, administration of magnesium sulfate (IV) has been shown to reduce hospital admission. However, for children, the evidence is low quality due to inconsistency of the magnesium sulfate doses used in only three studies. However, in most asthma guidelines, including GINA (2018), the governing guideline of this CPG, children greater than 6 years of age are treated as adults. GINA (2018) recommends considering magnesium (IV) for severe asthma exacerbations, or those that do not respond to conventional treatment.

Please click here for more information on Intravenous Magnesium Sulfate for Asthma Exacerbation.

References:
GINA. (2018). Global Strategy of Asthma Management and Prevention.

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.