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Randomised comparison of intravenous magnesium sulphate, terbutaline and aminophylline for children with acute severe asthma
Author(s) -
Singhi Sunit,
Grover Sudhanshu,
Bansal Arun,
Chopra Kapil
Publication year - 2014
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12780
Subject(s) - aminophylline , medicine , terbutaline , asthma , anesthesia , wheeze , adverse effect , acute severe asthma , vomiting , bronchodilator , nausea , salbutamol , respiratory disease , lung
Aim This study compared the efficacy of intravenous magnesium sulphate, terbutaline and aminophylline for children with acute, severe asthma poorly responsive to standard initial treatment. Methods We enrolled 100 children, aged one to 12 years, who had failed to respond to initial standard treatment for acute, severe asthma, in this randomised controlled trial. They received either intravenous magnesium sulphate, terbutaline or aminophylline. Responses were monitored using a modified Clinical Asthma Severity ( CAS ) score. The primary outcome was treatment success, defined as a reduction in the CAS of four points or more 1 h after starting the intervention. Results The magnesium sulphate group had higher treatment success (33/34, 97%) than the terbutaline and aminophylline groups (both 23/33, 70%) (p = 0.006) and faster resolution of retractions, wheeze and dyspnoea (p < 0.001). No adverse events occurred among patients receiving magnesium sulphate, but two patients receiving terbutaline had hypokalemia and nine patients receiving aminophylline had nausea and, or, vomiting. Conclusion Adding a single dose of Intravenous magnesium sulphate to inhaled beta2‐agonists and corticosteroids was more effective, and safer, than using terbutaline or aminophylline when treating a child with acute severe asthma poorly responsive to initial treatment.