{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:44:10Z","timestamp":1792075450733,"version":"4.4.0"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T00:00:00Z","timestamp":1786838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T00:00:00Z","timestamp":1786838400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100007833","name":"Hamad Medical Corporation","doi-asserted-by":"publisher","award":["$250\u2009000"],"award-info":[{"award-number":["$250\u2009000"]}],"id":[{"id":"10.13039\/100007833","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Determine if high\u2010dose intravenous magnesium with\/without nebulized budesonide for children with acute severe asthma is safe and reduces time to medical readiness for discharge compared to standard intravenous magnesium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Either 2 doses of intravenous magnesium or 1 dose and placebo, each with\/without high\u2010dose nebulized budesonide, were given in a double\u2010blind randomized trial to study patients in addition to standard\u2010of\u2010care asthma treatment. Time to medical readiness for discharge was the primary outcome. The proportion of patients discharged at 12, 18, and 24\u2009h, asthma severity scores at 4, 8, 12, and 24\u2009h, and safety of high\u2010dose magnesium were secondary outcomes. Follow\u2010up was 1\u2009week.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Covid\u201019 intervened to stop recuitment at 70% of the estimated 218 children planned. Primary and secondary results were similar for the 4 groups. High\u2010dose magnesium was safe on clinical and laboratory assessment. Exploratory analysis combining IV high\u2010dose magnesium groups compared to standard magnesium showed improvement of discharge ratio at 12\u2009h for the former. 40\/78 patients (51.2%) in high\u2010dose magnesium versus 26\/75 patients (34.6%) in the standard magnesium arms ready for discharge,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.038, absolute risk reduction 16.6%,95% CI, 0.93% to 31.1%. There was a trend toward improvement of PRAM score at 4 and 8\u2009h in the nebulized budesonide groups compared to placebo and no significant difference in seeking post\u2010discharge outpatient or need for inpatient care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High\u2010dose magnesium appeared safe with only a modest possible benefit of medical readiness for discharge at 12\u2009h. There was a reduction in asthma severity score at 4 and 8\u2009h from nebulized budesonide.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>\n                      , ID #NCT 02455687\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpc.70530","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T06:45:27Z","timestamp":1786949127000},"page":"1948-1958","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Pilot Placebo\u2010Controlled Randomized Trial of Repeated High\u2010Dose Intravenous Magnesium Sulphate and High\u2010Dose Nebulized Budesonide for Severe Asthma in the Paediatric Emergency Department"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8173-541X","authenticated-orcid":false,"given":"Khalid","family":"Alansari","sequence":"first","affiliation":[{"name":"Department of Pediatrics Emergency Sidra Medicine  Doha Qatar"},{"name":"Weill Cornell Medical College  Doha Qatar"},{"name":"Qatar University Medical College  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatin Abou","family":"Moussa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Emergency Hamad Medical Corporation  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7705-2170","authenticated-orcid":false,"given":"Hadi Abu","family":"Rasheed","sequence":"additional","affiliation":[{"name":"Qatar University Medical College  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5886-7892","authenticated-orcid":false,"given":"Bruce L.","family":"Davidson","sequence":"additional","affiliation":[{"name":"Retired  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid Yousif","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Emergency Hamad Medical Corporation  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Alrifaai","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Emergency Hamad Medical Corporation  Doha 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