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Intravenous magnesium sulfate is effective in preventing hospital admissions in children and adults with moderate-to-severe asthma exacerbations. However, this therapy requires an intravenous catheter and carries a small risk for hypotension, so nebulized magnesium has been proposed as an alternative.
More than 800 Canadian children with moderate-to-severe asthma exacerbations that were refractory to inhaled albuterol and ipratropium and systemic corticosteroids were randomized to receive three doses of nebulized magnesium sulfate or placebo in the emergency department. Need for hospitalization within 24 hours, an acute asthma composite score, pulse oximetry results, and need for additional albuterol all were similar in both groups.