Reviewing Magnesium Sulfate Treatment for Acute Asthma Exacerbations

This report critically evaluates the use of intravenous magnesium sulfate in treating acute asthma exacerbations in the emergency department, based on evidence from Rowe et al. The review addresses a focused clinical question regarding the effectiveness of magnesium sulfate, confirms the appropriateness of article selection criteria focusing on magnesium sulfate versus placebo, and validates the completeness of the documented search strategy. Methodological quality was independently assessed by two reviewers. The results, derived from 665 patients, indicate significant improvements in peak and forced expiratory flow rates with minimal side effects, supporting the use of magnesium sulfate specifically for severe acute asthma in emergency settings, but not for routine asthma management. The report references relevant studies, including Song & Wong, emphasizing the importance of minimal usage and highlighting the clinical benefits for severe acute asthma patients.

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The Treatment of Acute Asthma Exacerbations in the Emergency Department Using Magnesium
Sulfate
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Wd Count: 350

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Overview
The evidence by Rowe et al (1) suggests that the provision of intravenous magnesium sulfate has
been observed to be clinically safe and considerably beneficial to patients suffering from severe
acute asthma, or amongst individuals whose bronchodilators are no longer effective.
1. Does the review address a focussed clinical question?
Yes it addresses a focused clinical question: A clinical question needs to be considerably relevant
to patient's problem and provide a directive towards the acquisition of a possible solution. From
Rowe et al (1) evidence, it is clear that the review is directly linked to the examination of acute
asthma in patients and provides a clear path towards the retrieval of possible solutions in the use
of Magnesium Sulfate.
2. Were the criteria used to select articles for inclusion appropriate?
Yes, the review by Rowe et al (1) focuses on articles that are centred on the treatment of acute
Asthma exacerbation using Magnesium Sulfate against a placebo. Moreover, randomness was
used as the key selection component in the assessment, which eliminates biasness in the study
making it more reliable and accurate. In addition, the inclusion of such articles is highly
appropriate since the underlining objective is similar.
3. Was the search strategy documented and complete?
Yes, according to the results presented by Rowe et al (1), the search strategy was documented
and the all steps followed during the search process are clearly indicated: as such, we can
conclude that the search strategy is indeed complete.
4. Was the methodological quality of the primary trials addressed?
Yes, it was done independently by two reviewers.
5. What were the results of the review?

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The results by Rowe et al (1), indicate that peak and forced expiratory flow rate (measured in
L/min) were significantly improved at a 95% confidence level for the 665 patients employed in
the assessment. According to Song & Wong (2), it is important to note that the usage of
magnesium sulfate should always be kept to a minimum. As such, there were no clinically
significant side-effects or changes in the severe acute asthma subgroup of participants after the
dose of Magnesium Sulfate.
6. Will the results help you in caring for your patients?
Yes, the results Rowe et al (1), indicate that Magnesium Sulfate should be used only in the
treatment of severe acute asthma in the emergency department and should not be employed in
the routine management of acute asthma.

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References
1. Rowe B, Bretzlaff J, Bourdon C, Bota G, Blitz S, Camargo JC. Magnesium sulfate for treating
exacerbations of acute asthma in the emergency department. Cochrane Database of
Systematic Reviews [Internet] 2000 [cited 2018 October 31. Available from:
https://www.cochrane.org/CD001490/AIRWAYS_magnesium-sulfate-treating-exacerbations-
acute-asthma-emergency-department
2. Song WJ, Chang YS. Magnesium sulfate for acute asthma in adults: A systematic literature
review. Asia Pacific Allergy. 2018 Dec; 2(1):76-79.