Wolfson Children's Hospital/Baptist Health, Jacksonville, USA.
Intensive Care Med. 2013 Jan;39(1):117-22. doi: 10.1007/s00134-012-2734-6. Epub 2012 Nov 6.
To assess the safety and pharmacokinetics of high-dose magnesium sulfate (MgSO(4)) infusion in pediatric patients with status asthmaticus.
A prospective cohort study within a 20-bed pediatric intensive care unit in an academic community hospital. Patients 2-18 years of age admitted with status asthmaticus between 10/2009 and 8/2010 were included in the study. All patients received standard therapy for asthma, while the treatment group received an intravenous magnesium sulfate bolus of 50-75 mg/kg (0.2-0.3 mmol/kg) followed by 40 mg/kg/h (0.16 mmol/kg/h) for 4 h. Patients were monitored for cardiorespiratory complications. The treatment group underwent four blood draws to assess pharmacokinetic parameters.
Nineteen patients were in the treatment group and 38 patients in the control group after exclusion criteria and consenting were completed. No clinically significant differences were found between groups. There were no interventions or discontinuations of MgSO(4) due to adverse events. In the treatment group, three patients had mild infusion-related reactions. Heart rate and respiratory rate were statistically significantly lower in the magnesium treatment group.
The continuous infusions of MgSO(4) were safe at the studied doses and maintained serum magnesium (SrMg) and ionized magnesium levels similar to levels required to produce smooth muscle relaxation in other clinical settings. Further studies are needed to investigate the efficacy of high-dose continuous MgSO(4) infusion as an adjunctive treatment for severe asthma treatment and determine the SrMg level required to maintain airway smooth muscle relaxation.
评估高剂量硫酸镁（MgSO4）输注在哮喘持续状态儿科患者中的安全性和药代动力学。
在一家学术社区医院的 20 张病床儿科重症监护病房内进行前瞻性队列研究。2009 年 10 月至 2010 年 8 月期间，患有哮喘持续状态的 2-18 岁患者纳入研究。所有患者均接受哮喘标准治疗，而治疗组接受静脉注射硫酸镁负荷剂量 50-75mg/kg（0.2-0.3mmol/kg），随后 40mg/kg/h（0.16mmol/kg/h）输注 4 小时。监测患者的心肺并发症。治疗组进行了四次采血以评估药代动力学参数。
排除标准和同意完成后，治疗组有 19 例患者，对照组有 38 例患者。组间无临床显著差异。没有因不良事件而干预或停止硫酸镁治疗。在治疗组中，有 3 例患者出现轻度输液相关反应。硫酸镁治疗组的心率和呼吸频率均显著降低。
在所研究剂量下，硫酸镁持续输注是安全的，维持血清镁（SrMg）和离子化镁水平与其他临床环境中产生平滑肌松弛所需的水平相似。需要进一步研究高剂量连续硫酸镁输注作为重症哮喘治疗辅助治疗的疗效，并确定维持气道平滑肌松弛所需的 SrMg 水平。
