Effectof Nebulized Magnesium Sulphate On Children With Acute Asthma Attack:a Systematic Review And Meta-Analysis

Objective:To evaluate the effect of nebulized magnesium sulfate on children with acute asthma attack.Methods:Electronic literature search was performed up to July,2014 at the Cochrane Library, Pubmed, Medline,EMBASE,CBM, CNKI,VIP and Wan fang database.. The randomized controlled trails(RCTs) of nebulized magnesium sulphate for treating acute asthma in children were obtained, including the use of nebulized MgSO4 combined with bronchodilators and compared with the use of bronchodilators. The pulmonary function and adverse drug reaction were selected as primary and secondary outcomes. Data were pooled using random effects meta analysis of the standardized mean difference(SMD) in pulmonary function by RevMan software. The subgroup analysis was performed for each pulmonary function parameter and magnesium sulphate nebulized with and without other bronchodilators. Results:A total of 8 RCT studies involving 1161 patients wereincluded. ?Nebulized MgSO4 had no significant effect upon respiratory function (10min:SMD=-0.32,95%CI:-0.67to0.04,P=0.08;20min:SMD=-0.11,95%CI:-0.40 to 0.17,P=0.43) in children.?Subgroup analysis:MgSO4 was significantly inferior to salbutamol upon pulmonary function when compared with salbutamol(10min:SMD=-0.75,95%CI:-1.29 to-0.22,P=0.005;20min:SMD=-0.46,95%CI:-0.72to-0.20,P=0.006);Magnesiu m didn't show significant effect upon respiratory function(FEV1% predicted,PEF% predicted) to saline when used incombination with bronchodilators(FEV% predicthd after 10min:SMD:-0.03,95% CI:-0.52 to 0.46,P=0.89;PEF% predicted after 10min:SMD=-0.02,95%CI:-0.23 to 0.19,P=0.83;FEV1% predicted after 20 min:SMD=0.04,95%CI:-0.29 to 0.37,P=0.81;PEF% predictedafter 20 min:SMD=0.05,95%CI:-0.31 to 0.42,P=0.78).?Common adversed drug reaction of MgSO4,such as arrhythmia,decrement of myotasis reflex were not reported in included 8 studies.There was no difference in incidence of adverse drug reaction between MgSO4 and control groups.Conclusion:Nebulized MgSO4 as mono-therapy or combination with salbutamol in children with acute asthma attack appears to be less benefit in improving pulmonary function compared with salbutamol alone.