Efficacy of magnesium citrate cathartic in pediatric toxic ingestions.

STUDY OBJECTIVE

To investigate the efficacy of magnesium citrate in reducing gastrointestinal transit time of activated charcoal in children.

DESIGN

A prospective, randomized, clinical comparison of four magnesium doses.

SETTING

Urban children's hospital emergency department.

PARTICIPANTS

Children aged 1 month to 6 years who presented for management of an acute toxic ingestion.

INTERVENTION

Each child received 1 g/kg activated charcoal combined with a randomly assigned dose of a 6% solution of magnesium citrate: 0 mL/kg, 4 mL/kg (standard recommended dose), 6 mL/kg, or 8 mL/kg. The primary outcome measure was the interval to first activated charcoal-containing stool, which was determined by follow-up telephone call or review of the medical record.

RESULTS

Sixty-four children were enrolled. Median times to first charcoal stool were 19.5 hours (0 mL/kg), 13.0 hours (4 mL/kg), 14.0 hours (6 mL/kg), and 12.0 hours (8 mL/kg). Intergroup differences were significant by Kruskal-Wallis analysis of variance (P = .0035).

CONCLUSION

Magnesium citrate reduces gastrointestinal transit times of activated charcoal stools when administered to children who receive activated charcoal for a toxic ingestion. Further study is needed to determine the clinical value of this reduction.