Vaiyani Danish, Irazuzta Jose E
Wolfson Children's Hospital/Baptist Health and University of Florida College of Medicine, Jacksonville, Florida.
J Pediatr Pharmacol Ther. 2016 May-Jun;21(3):233-8. doi: 10.5863/1551-6776-21.3.233.
To determine the feasibility and safety of a simplified high-dose magnesium sulfate infusion (sHDMI) for the treatment of status asthmaticus.
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 > 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.
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.
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.
确定简化高剂量硫酸镁输注（sHDMI）治疗哮喘持续状态的可行性和安全性。
我们回顾性比较了2种不同的高剂量硫酸镁输注方案，将其作为哮喘持续状态的辅助治疗，使用先前收集的数据。最初的高剂量、长时间硫酸镁输注（HDMI）方案包括在30至45分钟内给予负荷剂量75mg/kg（体重≤30kg）或50mg/kg（体重>30kg），随后以40mg/kg/小时的速度持续输注4小时。将其与sHDMI方案进行比较，sHDMI方案为以50mg/kg/小时的速度输注5小时。sHDMI组的患者未给予负荷剂量。肥胖患者按理想体重给药。在输注硫酸镁期间监测生理参数（即心率、血压、呼吸频率、血氧饱和度）和血清镁（SrMg）浓度。
将19例接受初始HDMI方案的患者与10例接受sHDMI方案的患者进行比较。两种剂量方案之间的SrMg浓度或生理参数无显著差异。
HDMI和sHDMI方案均产生了与支气管扩张相关的SrMg浓度。两种方案的安全性也相似。sHDMI的明确性有可能减少与负荷剂量计算、产品制备和最终给药相关的用药错误。
