Question
How many doses of magnesium sulfate can be safely used in a severe asthmatic status with a Wood-Downes score of 6?
Roberto Lopez Vallecillo, MD
Response From the Expert
Acute asthma often represents failure of outpatient management, and the goal of treatment of these patients is to restore them to a state of quiet breathing, without complication. This is often achieved by pharmacotherapy. Glover and colleagues demonstrated in a group of patients admitted to the pediatric intensive care unit that intravenous magnesium sulfate administered via continuous infusion represents a safe mode of drug delivery for the treatment of refractory wheezing.
Magnesium sulfate may be safely used in children with refractory asthma. The recommended dose is 45 mg/kg IV. The dose may be repeated with a total dose of 75 mg/kg up to 2.5 g.