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Several studies have demonstrated that intravenous magnesium sulfate has significant bronchodilating effects in patients with severe asthma exacerbations. In a randomized, double-blind, placebo-controlled trial, these authors assessed whether magnesium sulfate delivered by nebulization also is effective.
Patients were eligible if peak flow measurements were below 50% of predicted 30 minutes after they received nebulized salbutamol and IV hydrocortisone. Those requiring immediate intubation and those with pneumonia or COPD were excluded. Fifty-two patients received 3 additional treatments of 2.5-mg salbutamol mixed with either 2.5-mL isotonic magnesium sulfate (151 mg/dose; 28 patients) or 2.5-mL isotonic saline (24 patients). The isotonic fo…