A COMPARATIVE STUDY OF MAGNASIUM SULFATE IN TREATING PEDIATRIC ACUTE BRONCHIOLITIS
DOI:
https://doi.org/10.55519/JAMC-S4-14160Keywords:
Acute bronchiolitis, magnesium sulfate, hypertonic saline, pediatric, respiratory outcomes, prospective cohort studyAbstract
Background: Acute bronchiolitis is a common respiratory disease in children that often necessitates hospitalization. Treatments for this condition include bronchodilators and supportive care. Although magnesium sulfate and hypertonic saline have been proposed as possible therapies, it is yet unknown how successful they are in comparison. This study aimed to compare the clinical efficacy, safety, and impact on respiratory outcomes of nebulized magnesium sulfate versus hypertonic saline in treating pediatric acute bronchiolitis. Methods: A prospective cohort study was conducted at Bannu Medical College, MTI Bannu, from January to December 2023. A total of 120 children (ages 2 months to 2 years) diagnosed with acute bronchiolitis were randomly assigned into two groups: Group A received nebulized magnesium sulfate (0.1cc/kg of 50% solution) every 8 hours for 24 hours, while Group B received nebulized hypertonic saline (3%, 4cc) every 8 hours for 24 hours. Both groups received standard supportive care. Primary outcomes included improvements in respiratory distress scores, oxygen saturation, wheezing, and respiratory rate. Secondary outcomes assessed hospital stay duration, side effects, and the need for additional treatment. Data were analyzed using independent t-tests for continuous variables and chi-square tests for categorical variables, with statistical significance set at p<0.05. Results: Both treatments significantly improved respiratory distress scores and oxygenation. However, Group A (magnesium sulfate) showed greater reductions in wheezing and respiratory rate compared to Group B (hypertonic saline) (p<0.05). Additionally, hospital stay duration was shorter in Group A (mean±SD: 3.2±0.9 days) compared to Group B (3.8±1.1 days, p=0.03). No severe side effects were observed in either group. Conclusion: Nebulized magnesium sulfate demonstrated superior efficacy in improving respiratory distress and reducing hospital stay duration compared to hypertonic saline, suggesting its potential as a more effective treatment option for pediatric acute bronchiolitis. These findings highlight the need for further large-scale randomized controlled trials to confirm these results and refine treatment protocols.
References
References
1. Ali S, Plint AC, Klassen TP. Bronchiolitis. Kendig & Chernick's Disorders of the Respiratory Tract in Children. 2012:443–52. doi: 10.1016/B978-1-4377-1984-0.00027-9. Epub 2012 Apr 15. PMCID: PMC7152281.
2. Fretzayas A, Moustaki M. Etiology and clinical features of viral bronchiolitis in infancy. World Journal of Pediatrics. 2017 Aug;13:293-9. https://doi.org/10.1007/s12519-017-0031-8.
3. Ghazaly M, Nadel S. Overview of prevention and management of acute bronchiolitis due to respiratory syncytial virus. Expert Review of Anti-infective Therapy. 2018 Dec 2;16(12):913-28. https://doi.org/10.1080/14787210.2018.1543589.
4. Ljubin-Sternak S, Meštrović T, Lukšić I, Mijač M, Vraneš J. Seasonal coronaviruses and other neglected respiratory viruses: a global perspective and a local snapshot. Frontiers in public health. 2021 Jul 5;9:691163. https://doi.org/10.3389/fpubh.2021.691163.
5. Doenhardt M, Armann JP, Diffloth N, Gano C, Schneider J, Schneider DT, Tenenbaum T, Trotter A, Berner R. High burden of acute respiratory tract infections leading to hospitalization at German pediatric hospitals: fall/winter 2022–2023. Infection. 2024 Apr;52(2):525-34. https://doi.org/10.1007/s15010-023-02123-7.
6. Verma N, Lodha R, Kabra SK. Recent advances in management of bronchiolitis. Indian pediatrics. 2013 Oct;50:939-49. https://doi.org/10.1007/s13312-013-0265-z.
7. Kirolos A, Manti S, Blacow R, Tse G, Wilson T, Lister M, Cunningham S, Campbell A, Nair H, Reeves RM, Fernandes RM. A systematic review of clinical practice guidelines for the diagnosis and management of bronchiolitis. The Journal of infectious diseases. 2020 Nov 1;222(Supplement_7):S672-9. https://doi.org/10.1093/infdis/jiz240.
8. Ghazaly M, Nadel S. Overview of prevention and management of acute bronchiolitis due to respiratory syncytial virus. Expert Review of Anti-infective Therapy. 2018 Dec 2;16(12):913-28. https://doi.org/10.1080/14787210.2018.1543589
9. Kua KP, Lee SW. Complementary and alternative medicine for the treatment of bronchiolitis in infants: A systematic review. PloS one. 2017 Feb 17;12(2):e0172289. https://doi.org/10.1371/journal.pone.0172289
10. Lun E. Hon K, Leung AK. Medications and recent patents for status asthmaticus in children. Recent Patents on Inflammation & Allergy Drug Discovery. 2017 May 1;11(1):12-21. https://doi.org/10.2174/1872213X11666170130143524.
11. Edwards DA, Chung KF. Mouth breathing, dry air, and low water permeation promote inflammation, and activate neural pathways, by osmotic stresses acting on airway lining mucus. QRB discovery. 2023 Jan;4:e3. doi:10.1017/qrd.2023.1.
12. Modaresi MR, Faghihinia J, Kelishadi R, Reisi M, Mirlohi S, Pajhang F, Sadeghian M. Nebulized magnesium sulfate in acute bronchiolitis: a randomized controlled trial. The Indian Journal of Pediatrics. 2015 Sep;82:794-8. https://doi.org/10.1007/s12098-015-1729-z.
13. Chandelia S, Kumar D, Chadha N, Jaiswal N. Magnesium sulphate for treating acute bronchiolitis in children up to two years of age. Cochrane Database of Systematic Reviews. 2020(12). https://doi.org/10.1002/14651858.CD012965.pub2.
14. Albuali WH. The use of intravenous and inhaled magnesium sulphate in management of children with bronchial asthma. The Journal of Maternal-Fetal & Neonatal Medicine. 2014 Nov 1;27(17):1809-15. https://doi.org/10.3109/14767058.2013.876620.
15. Abdelkreem E, Mahmoud SM, Aboelez MO, Abd El Aal M. Nebulized magnesium sulfate for treatment of persistent pulmonary hypertension of newborn: a pilot randomized controlled trial. Indian Journal of Pediatrics. 2021 Aug;88:771-7. https://doi.org/10.1007/s12098-020-03643-y.
16. El Ghaiaty HA, Ismael YM, Assar EH, Elsayed AM. Role of Nebulized Magnesium Sulfate Versus Nebulized Budesonide In treatment of Acute Bronchiolitis and Its Outcome. Benha Journal of Applied Sciences. 2021 Dec 1;6(6):267-73. DOI: 10.21608/BJAS.2021.214825.
17. Guruprasad N, Mithra CG, Ratageri VH. Efficacy of nebulized magnesium sulfate in moderate bronchiolitis. Journal of Pediatric Critical Care. 2022 May 1;9(3):90-4. DOI: 10.4103/jpcc.jpcc_11_22.
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Ansar Hussain, Khalil Ahmad, Haji Gul, Muhammad Ibrahim, Habib Ur Rehman , Muhammad Rafiq Khan

This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.