Department of Pediatric Critical Care, University of Wisconsin, Madison, Wisconsin.
Department of Pediatric Critical Care, Nemours/Alfred I DuPont Hospital for Children, Wilmington, Delaware.
Pediatr Pulmonol. 2018 Jul;53(7):866-871. doi: 10.1002/ppul.24013. Epub 2018 Apr 16.
Magnesium is an adjunctive therapy used in patients with status asthmaticus who do not respond to conventional therapy. The optimal time from initiation of therapy, to determination of response and administration of magnesium has not yet been resolved. Our objective was to determine if magnesium administered in the non-intensive care setting can decrease duration of continuous albuterol and hospital length of stay.
We performed a retrospective cohort analysis of children ages 2-18 years admitted to the pediatric unit on continuous albuterol between January 2014 and December 2015 in a tertiary care children's hospital. Cohorts were matched on respiratory assessment score (RAS) obtained at a similar duration of albuterol therapy and evaluated for the total duration of continuous albuterol, length of stay (LOS), and adverse events.
Thirty-three patients who received magnesium were matched to 33 patients with the same RAS at a similar duration of continuous albuterol therapy who did not receive magnesium. Those who received magnesium had longer duration on continuous albuterol (34 vs 18 h; P = 0.001; 95% confidence interval [CI] 4-20; effect size 0.41) and longer LOS (72 vs 49 h; P = 0.037; 95% confidence interval [CI] 1-33; effect size 0.26) than those who did not receive magnesium.
Children requiring continuous albuterol for status asthmaticus can be administered magnesium sulfate outside the PICU with a low incidence of adverse events; however, among a RAS matched cohort, those who received magnesium did not experience shorter time on continuous albuterol, or hospital length of stay.
在对常规治疗无反应的哮喘持续状态患者中，镁是一种辅助治疗方法。从开始治疗到确定反应和给予镁的最佳时间尚未确定。我们的目的是确定在非重症监护病房给予镁是否可以缩短持续使用沙丁胺醇的时间和住院时间。
我们对 2014 年 1 月至 2015 年 12 月期间在一家三级儿童医院接受连续沙丁胺醇治疗的 2-18 岁儿科病房住院的儿童进行了回顾性队列分析。根据接受沙丁胺醇治疗相似时间获得的呼吸评估评分（RAS）对两组进行匹配，并评估连续使用沙丁胺醇的总时间、住院时间（LOS）和不良事件。
33 例接受镁治疗的患者与 33 例接受相同 RAS 的患者相匹配，这些患者在接受相似时间的连续沙丁胺醇治疗时未接受镁治疗。接受镁治疗的患者持续使用沙丁胺醇的时间更长（34 小时与 18 小时；P = 0.001；95%置信区间 [CI] 4-20；效应大小 0.41），住院时间更长（72 小时与 49 小时；P = 0.037；95%置信区间 [CI] 1-33；效应大小 0.26）比未接受镁治疗的患者。
对于哮喘持续状态需要连续使用沙丁胺醇的儿童，可以在 PICU 外给予硫酸镁，不良事件发生率低；然而，在 RAS 匹配的队列中，接受镁治疗的患者并没有经历更短的持续使用沙丁胺醇时间或住院时间。
