High-dose intravenous magnesium sulfate in the management of life-threatening status asthmaticus — authors' reply

1995 ◽  
Vol 21 (1) ◽  
pp. 94-95
Author(s):  
M. Sydow ◽  
T. A. Crozier ◽  
S. Zielmann ◽  
J. Radke ◽  
H. Burchardi
Keyword(s):  
Magnesium Sulfate ◽  
Status Asthmaticus ◽  
High Dose ◽  
Intravenous Magnesium ◽  
Life Threatening

High-dose intravenous magnesium sulfate in the management of life-threatening status asthmaticus

1993 ◽  
Vol 19 (8) ◽  
pp. 467-471 ◽  
Author(s):  
M. Sydow ◽  
T. A. Crozier ◽  
S. Zielmann ◽  
J. Radke ◽  
H. Burchardi
Keyword(s):  
Magnesium Sulfate ◽  
Status Asthmaticus ◽  
High Dose ◽  
Intravenous Magnesium ◽  
Life Threatening

scholarly journals The Effect of Early Treatment with Intravenous Magnesium Sulfate on the Incidence of Cardiac Comorbidities in Hospitalized Stroke Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Kameron Bechler ◽  
Kristina Shkirkova ◽  
Jeffrey L. Saver ◽  
Sidney Starkman ◽  
Scott Hamilton ◽  
...  
Keyword(s):  
Adverse Events ◽  
Acute Stroke ◽  
Magnesium Sulfate ◽  
Serum Magnesium ◽  
High Dose ◽  
Stroke Patients ◽  
Serious Adverse Events ◽  
Intravenous Magnesium ◽  
Prophylactic Measures ◽  
Cardiac Adverse Events

Background. Cardiac adverse events are common among patients presenting with acute stroke and contribute to overall morbidity and mortality. Prophylactic measures for the reduction of cardiac adverse events in hospitalized stroke patients have not been well understood. We sought to investigate the effect of early initiation of high-dose intravenous magnesium sulfate on cardiac adverse events in stroke patients. Methods. This is a secondary analysis of the prehospital Field Administration of Stroke Therapy-Magnesium (FAST-MAG) randomized phase-3 clinical trial, conducted from 2005-2013. Consecutive patients with suspected acute stroke and a serum magnesium level within 72 hours of enrollment were selected. Twenty grams of magnesium sulfate or placebo was administered in the ambulance starting with a 15-minute loading dose intravenous infusion followed by a 24-hour maintenance infusion in the hospital. Results. Among 1126 patients included in the analysis of this study, 809 (71.8%) patients had ischemic stroke, 277 (24.6%) had hemorrhagic stroke, and 39 (3.5%) with stroke mimics. The mean age was 69.5 (SD13.4) and 42% were female. 565 (50.2%) received magnesium treatment, and 561 (49.8%) received placebo. 254 (22.6%) patients achieved the target, and 872 (77.4%) did not achieve the target, regardless of their treatment group. Among 1126 patients, 159 (14.1%) had at least one CAE. Treatment with magnesium was not associated with fewer cardiac adverse events. A multivariate binary logistic regression for predictors of CAEs showed a positive association of older age and frequency of CAEs (R=1.04, 95% CI 1.03-1.06, p<0.0001). Measures of early and 90-day outcomes did not differ significantly between the magnesium and placebo groups among patients who had CAEs. Conclusion. Treatment of acute stroke patients with magnesium did not result in a reduction in the number or severity of cardiac serious adverse events.

Failure of High-Dose Intravenous Magnesium Sulfate to Control Myoclonic Status Epilepticus

1988 ◽  
Vol 11 (6) ◽  
pp. 537-544 ◽  
Author(s):  
Robert S. Fisher ◽  
Peter W. Kaplan ◽  
Allan Krumholz ◽  
Ronald P. Lesser ◽  
Steven A. Rosen ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Magnesium Sulfate ◽  
High Dose ◽  
Intravenous Magnesium

Intravenous magnesium sulfate treatment in a child with status asthmaticus

1999 ◽  
Vol 56 (10) ◽  
pp. 997-1000 ◽  
Author(s):  
Jean G. Dib ◽  
Fayette M. Engstrom ◽  
Thomas S. Sisca ◽  
Raquel M. Tiu
Keyword(s):  
Magnesium Sulfate ◽  
Status Asthmaticus ◽  
Intravenous Magnesium

High-dose magnesium sulfate infusion protocol for status asthmaticus: a safety and pharmacokinetics cohort study

2012 ◽  
Vol 39 (1) ◽  
pp. 117-122 ◽  
Author(s):  
Tosha A. Egelund ◽  
Sarah K. Wassil ◽  
Elisa M. Edwards ◽  
Stephan Linden ◽  
Jose E. Irazuzta
Keyword(s):  
Cohort Study ◽  
Magnesium Sulfate ◽  
Status Asthmaticus ◽  
High Dose ◽  
Infusion Protocol

Resuscitation from prolonged cardiac arrest with high-dose intravenous magnesium sulfate

1991 ◽  
Vol 9 (6) ◽  
pp. 469-476 ◽  
Author(s):  
Lane Craddock ◽  
Brian Miller ◽  
Guy Clifton ◽  
Barbara Krumbach ◽  
William Pluss
Keyword(s):  
Cardiac Arrest ◽  
Magnesium Sulfate ◽  
High Dose ◽  
Intravenous Magnesium

Intravenous magnesium sulfate in acute, life-threatening asthma

1991 ◽  
Vol 20 (11) ◽  
pp. 1243-1245 ◽  
Author(s):  
Lieske M Kuitert ◽  
Sharon L Kletchko
Keyword(s):  
Magnesium Sulfate ◽  
Intravenous Magnesium ◽  
Life Threatening

Treatment of Status Asthmaticus with Intravenous Magnesium Sulfate

1991 ◽  
Vol 28 (1) ◽  
pp. 11-17 ◽  
Author(s):  
Hiroshi Okayama ◽  
Michiko Okayama ◽  
Takashi Aikawa ◽  
Midetada Sasaki ◽  
Tamotsu Takishima
Keyword(s):  
Magnesium Sulfate ◽  
Status Asthmaticus ◽  
Intravenous Magnesium

scholarly journals Feasibility of Short-Term Infusion of Magnesium Sulfate in Pediatric Patients With Status Asthmaticus

2012 ◽  
Vol 17 (2) ◽  
pp. 150-154 ◽  
Author(s):  
Jose Irazuzta ◽  
Tosha Egelund ◽  
Sarah K. Wassil ◽  
Christian Hampp
Keyword(s):  
Magnesium Sulfate ◽  
Pediatric Patients ◽  
Status Asthmaticus ◽  
Serum Magnesium ◽  
Linear Regression Analysis ◽  
Active Form ◽  
Case Series ◽  
Retrospective Chart Review ◽  
High Dose ◽  
Short Term

OBJECTIVE This report describes the feasibility of high-dose magnesium sulfate infusion in pediatric patients with status asthmaticus. METHODS Retrospective chart review over a 3-year period of all patients younger than 18 years of age with status asthmaticus who underwent a high-dose magnesium sulfate infusion for 4 hours. All patients were breathing spontaneously but were refractory to conventional therapy. The magnesium sulfate infusion regimen was 50 mg/kg (for patients weighing &gt;30 kg) or 75 mg/kg (for those weighing ≤30 kg) over a period of 30 to 45 minutes, followed by a continuous infusion of 40 mg/kg/hr for 4 hours. Information regarding vital and clinical respiratory signs, serum magnesium (SrMg), ionized magnesium (iMg), electrocardiograms, and cardiac troponin levels were retrieved. We analyzed the relationship between SrMg and iMg by using linear regression analysis. RESULTS Nineteen patients were included. At the end of the infusion, SrMg levels were 4.4 ± 0.8 mg/dL, and iMg levels were 0.95 ± 0.2 mmol/L. SrMg levels only moderately predicted iMg (r2 = 0.541). There were no reports of hypotension, respiratory failure, neurological problems, or nausea. Discomfort at the site of infusion was reported in three cases. Troponin levels (n = 12) and electrocardiograms (n = 12), when available, were noted at the end of the infusion and were normal in all patients p=0.01. CONCLUSIONS In this case series, short-term high-dose administration of magnesium sulfate in the context of status asthmaticus was feasible, and we did not observe clinical complications with its use. Total SrMg was inadequate to reflect the active form of magnesium, iMg. The dose used achieved theoretical therapeutic levels of iMg.

scholarly journals Comparison of Two High-Dose Magnesium Infusion Regimens in the Treatment of Status Asthmaticus

2016 ◽  
Vol 21 (3) ◽  
pp. 233-238
Author(s):  
Danish Vaiyani ◽  
Jose E. Irazuzta
Keyword(s):  
Magnesium Sulfate ◽  
Status Asthmaticus ◽  
Serum Magnesium ◽  
Ideal Body Weight ◽  
Adjunctive Treatment ◽  
High Dose ◽  
Loading Dose ◽  
Significant Difference ◽  
Physiologic Parameters ◽  
Using Data

OBJECTIVES: To determine the feasibility and safety of a simplified high-dose magnesium sulfate infusion (sHDMI) for the treatment of status asthmaticus. METHODS: We retrospectively compared 2 different high-dose magnesium sulfate infusion regimens, as adjunctive treatment in status asthmatics, using data that were preciously collected. The initial high-dose, prolonged magnesium infusion (HDMI) regimen consisted of a loading dose of 75 mg/kg (weight ≤ 30 kg) or 50 mg/kg (weight &gt; 30 kg) over a period of 30 to 45 minutes followed by a continuous infusion of 40 mg/kg/hr for an additional 4 hours. This was compared to the sHDMI regimen that consisted of 50 mg/kg/hr for 5 hours. No loading dose was given to the patients in the sHDMI arm. Obese patients were dosed by using ideal body weight. Physiologic parameters (i.e., heart rate, blood pressure, respiratory rate, oxygen saturation) and serum magnesium (SrMg) concentrations were monitored during administration of magnesium sulfate. RESULTS: Nineteen patients receiving the initial HDMI regimen were compared with 10 patients who received the sHDMI regimen. There was no significant difference in SrMg concentrations or physiologic parameters between the 2 dose regimens. CONCLUSIONS: The HDMI and sHDMI regimens both produced SrMg concentrations that are associated with bronchodilation. The safety profile was also similar for the 2 regimens. The unambiguity of sHDMI has the potential to reduce medication errors that are associated with calculation of the loading dose, product preparation, and ultimate administration.

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