Annals of Emergency Medicine
Volume 36, Issue 3 , Pages 191-197 , September 2000

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

Presented in poster format at the Society for Academic Emergency Medicine, Boston, MA, May 1999.

  • Harrison J. Alter, MS, MD

      Affiliations

    • Robert Wood Johnson Clinical Scholars Program
    • ,
  • Thomas D. Koepsell, MD, MPH

      Affiliations

    • Department of Epidemiology
    • ,
  • William M. Hilty, MD

      Affiliations

    • University of Washington, Seattle, WA; and the Department of Emergency Medicine, Saint Mary’s Hospital and Medical Center, Grand Junction, CO.

Received 12 October 1999 ,Revised 3 May 2000 ,Accepted 17 May 2000.

References 

  1. Noppen M, Vanmaele L, Impens N, et al.  Bronchodilating effect of intravenous magnesium sulfate in acute severe bronchial asthma. Chest. 1990;97:373–376
  2. Corbridge TC, Hall JB. The assessment and management of adults with status asthmaticus. Am J Respir Crit Care Med. 1995;151:1296–1316
  3. Skobeloff EM, Spivey WH, McNamara RM, et al.  Intravenous magnesium sulfate for the treatment of acute asthma in the emergency department. JAMA. 1989;262:1210–1213
  4. Rowe BH, Bretzlaff JA, Bourdon C, et al.  Magnesium sulfate is effective for severe acute asthma treated in the emergency department. ACP J Club. 1999;131:36
  5. Littenberg B. Aminophylline treatment in severe, acute asthma. A meta-analysis. JAMA. 1988;259:1678–1684
  6. Jadad AR, Moore RA, Carroll D, et al.  Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials. 1996;17:1–12
  7. Rosenthal R. Parametric measures of effect size. In:  Cooper H,  Hedges LV editor. The Handbook of Research Synthesis. New York, NY: Russell Sage Foundation; 1994;p. 231–244
  8. Pettiti DB. Meta-Analysis, Decision Analysis, and Cost-effectiveness Analysis: Methods for Quantitative Synthesis in Medicine.. New York, NY: Oxford University Press; 1994;
  9. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177–188
  10. Fleiss JL. The statistical basis of meta-analysis. Stat Methods Med Res. 1993;2:121–145
  11. Ferret RL. Graphical methods for detecting bias in meta-analysis. Fam Med. 1998;30:579–583
  12. Egger M, Davey Smith G, Schneider M, et al.  Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–634 [see comments]
  13. Oler A, Whooley MA, Oler J, et al.  Adding heparin to aspirin reduces the incidence of myocardial infarction and death in patients with unstable angina. A meta-analysis. JAMA. 1996;276:811–815
  14. Rolla G, Bucca C, Bugiani M, et al.  Reduction of histamine-induced bronchoconstriction by magnesium in asthmatic subjects. Allergy. 1987;42:186–188
  15. Rolla G, Bucca C, Arossa W, et al.  Magnesium attenuates methacholine-induced bronchoconstriction in asthmatics. Magnesium. 1987;6:201–204
  16. Rolla G, Bucca C, Brussino L, et al.  Effect of intravenous magnesium infusion on salbutamol-induced bronchodilatation in patients with asthma. Magnes Res. 1994;7:129–133
  17. Bernstein WK, Khastgir T, Khastgir A, et al.  Lack of effectiveness of magnesium in chronic stable asthma. A prospective, randomized, double-blind, placebo-controlled, crossover trial in normal subjects and in patients with chronic stable asthma. Arch Intern Med. 1995;155:271–276
  18. Rolla G, Bucca C, Carla E, et al.  Acute effect of intravenous magnesium sulfate on airway obstruction of asthmatic patients. Ann Allergy. 1988;61:388–391
  19. Sharma SK, Bhargava A, Pande JN. Effect of parenteral magnesium sulfate on pulmonary functions in bronchial asthma. J Asthma. 1994;31:109–115
  20. Chande VT, Skoner DP. A trial of nebulized magnesium sulfate to reverse bronchospasm in asthmatic patients. Ann Emerg Med. 1992;21:1111–1115
  21. Hill JM, Britton J. Effect of intravenous magnesium sulphate on airway calibre and airway reactivity to histamine in asthmatic subjects. Br J Clin Pharmacol. 1996;42:629–631
  22. Brunner EH, Delabroise AM, Haddad ZH. Effect of parenteral magnesium on pulmonary function, plasma cAMP, and histamine in bronchial asthma. J Asthma. 1985;22:3–11
  23. Sydow M, Crozier TA, Zielmann S, et al.  High-dose intravenous magnesium sulfate in the management of life- threatening status asthmaticus. Intensive Care Med. 1993;19:467–471 [see comments]
  24. Lemesle FG. High-dose intravenous magnesium sulfate in the management of life-threatening status asthmaticus. Intensive Care Med. 1995;21:94–95 [letter; comment]
  25. Hill J, Lewis S, Britton J. Studies of the effects of inhaled magnesium on airway reactivity to histamine and adenosine monophosphate in asthmatic subjects. Clin Exp Allergy. 1997;27:546–551
  26. Emel’ianova AV, Goncharova VA, Sinitsina TM. The efficacy of the magnesium sulfate aerosol treatment of bronchial asthma patients. Ter Arkh. 1997;69:35–39 [Russian]
  27. Manzke H, Thiemeier M, Elster P, et al.  Magnesium sulfate as adjuvant in beta-2-sympathicomimetic inhalation therapy of bronchial asthma. Pneumologie. 1990;44:1190–1192 [German]
  28. Emel’ianova AV, Goncharova VA, Sinitsina TM. Magnesium sulfate in management of bronchial asthma. Klin Med (Mosk). 1996;74:55–58 [Russian]
  29. Mangat HS, D’Souza GA, Jacob MS. Nebulized magnesium sulphate versus nebulized salbutamol in acute bronchial asthma: a clinical trial. Eur Respir J. 1998;12:341–344
  30. Meral A, Coker M, Tanac R. Inhalation therapy with magnesium sulfate and salbutamol sulfate in bronchial asthma. Turk J Pediatr. 1996;38:169–175
  31. Hill J, Britton J. Dose-response relationship and time-course of the effect of inhaled magnesium sulphate on airflow in normal and asthmatic subjects. Br J Clin Pharmacol. 1995;40:539–544
  32. Emel’ianov AV, Fedoseev GB, Emanuel VL. Effects of magnesium sulfate aerosol on indices of external respiration in patients with bronchial asthma. Klin Med (Mosk). 1990;68:31–34 [Russian]
  33. Fedoseev GB, Emel’ianov AV, Malakauskas KK, et al.  The therapeutic potentials of magnesium sulfate in bronchial asthma. Ter Arkh. 1991;63:27–29 [Russian]
  34. Portel L, Hilbert G, Gruson D, et al.  Malignant hyperthermia and neuroleptic malignant syndrome in a patient during treatment for acute asthma. Acta Anaesthesiol Scand. 1999;43:107–110
  35. Pabon H, Monem G, Kissoon N. Safety and efficacy of magnesium sulfate infusions in children with status asthmaticus. Pediatr Emerg Care. 1994;10:200–203
  36. Okayama H, Aikawa T, Okayama M, et al. Bronchodilating effect of intravenous magnesium sulfate in bronchial asthma. JAMA. 987;257:1076-1078.
  37. Hauser SP, Braun PH. Intravenous magnesium administration in bronchial asthma. Schweiz Med Wochenschr. 1989;119:1633–1635 [German]
  38. Leber MJ, Rao S, Birrer RB. Magnesium sulfate used as an adjunct to beta-agonists in acute asthma: a case report. J Emerg Med. 1991;9:377; [letter]
  39. Kuitert LM, Kletchko SL. Intravenous magnesium sulfate in acute, life-threatening asthma. Ann Emerg Med. 1991;20:1243–1245 [published erratum appears in Ann Emerg Med. 1992;21:1272]
  40. Schiermeyer RP, Finkelstein JA. Rapid infusion of magnesium sulfate obviates need for intubation in status asthmaticus. Am J Emerg Med. 1994;12:164–166
  41. Mills R, Leadbeater M, Ravalia A. Intravenous magnesium sulphate in the management of refractory bronchospasm in a ventilated asthmatic. Anaesthesia. 1997;52:782–785
  42. Skobeloff EM, Kim D, Spivey WH. Magnesium sulfate for the treatment of bronchospasm complicating acute bronchitis in a four-months’-pregnant woman. Ann Emerg Med. 1993;22:1365–1367
  43. Bloch H, Silverman R, Mancherje N, et al.  Intravenous magnesium sulfate as an adjunct in the treatment of acute asthma. Chest. 1995;107:1576–1581
  44. Ciarallo L, Sauer AH, Shannon MW. Intravenous magnesium therapy for moderate to severe pediatric asthma: results of a randomized, placebo-controlled trial. J Pediatr. 1996;129:809–814
  45. Tiffany BR, Berk WA, Todd IK, et al.  Magnesium bolus or infusion fails to improve expiratory flow in acute asthma exacerbations. Chest. 1993;104:831–834
  46. Skorodin MS, Tenholder MF, Yetter B, et al.  Magnesium sulfate in exacerbations of chronic obstructive pulmonary disease. Arch Intern Med. 1995;155:496–500
  47. Green SM, Rothrock SG. Intravenous magnesium for acute asthma: failure to decrease emergency treatment duration or need for hospitalization. Ann Emerg Med. 1992;21:260–265
  48. Devi PR, Kumar L, Singhi SC, et al.  Intravenous magnesium sulfate in acute severe asthma not responding to conventional therapy. Indian Pediatr. 1997;34:389–397
  49. Silverman R, Osborne H, Runge J, et al.  Magnesium sulfate as an adjunct to standard therapy in acute severe asthma. Acad Emerg Med. 1996;3:467–468 [abstract]
  50. Matusiewicz SP, Cusack S, Greening AP, et al.  A double blind placebo controlled parallel group study of intravenous magnesium sulphate in acute severe asthma. Eur Respir J. 1994;18:14S; [abstract]
  51. Rodrigo G, Rodrigo C, Burschtin O. A meta-analysis of the effects of ipratropium bromide in adults with acute asthma. Am J Med. 1999;107:363–370
  52. Cohen J. Statistical Power Analysis for the Behavioral Sciences. In: 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988;p. 567
  53. Sharp S, Steme J. sbe16: Meta-analysis. Stata Technical Bulletin. 1997;38:9–14

☆ Address for reprints: Harrison J. Alter, MS, MD, Division of Emergency Medicine, University of Washington, Box 356123, Seattle, WA 98195-6123; 206-598-3345, fax 206-598-4569; E-mail halter@u.washington.edu .

PII: S0196-0644(00)27984-5

doi: 10.1067/mem.2000.109170

Annals of Emergency Medicine
Volume 36, Issue 3 , Pages 191-197 , September 2000

Article Tools

* Image Usage & Resolution