{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T16:31:38Z","timestamp":1740155498437,"version":"3.37.3"},"reference-count":38,"publisher":"European Respiratory Society (ERS)","issue":"4","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ersjournals.com"],"crossmark-restriction":true},"short-container-title":["Breathe"],"accepted":{"date-parts":[[2021,10,5]]},"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:p>What is the most appropriate second-line intravenous bronchodilator treatment when a child with a severe asthma attack is not responsive to initial inhaled therapy? The second-line treatment options for acute asthma include parenteral \u03b2<jats:sub>2<\/jats:sub>-agonists, methylxanthine and magnesium sulphate (MgSO<jats:sub>4<\/jats:sub>). There is a poor evidence-base to inform this decision. This review argues that intravenous MgSO<jats:sub>4<\/jats:sub>is the obvious treatment of choice for this situation as the initial treatment based on current knowledge.\u00a0 We describe the mode of action, scope and limitations of MgSO<jats:sub>4<\/jats:sub>, safety profile, economic impact, comparisons of the alternatives, and finally, what the guidelines say.\u00a0 This review explores the suitability of intravenous MgSO<jats:sub>4<\/jats:sub>\u00a0as a pragmatic and safe initial second-line therapy for children unresponsive to initial asthma management.<\/jats:p>","DOI":"10.1183\/20734735.0113-2021","type":"journal-article","created":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T15:56:06Z","timestamp":1641916566000},"page":"210113","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Stating the obvious: intravenous magnesium sulphate should be the first parenteral bronchodilator in paediatric asthma exacerbations unresponsive to first-line therapy"],"prefix":"10.1183","volume":"17","author":[{"given":"Gokul","family":"Erumbala","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabu","family":"Anzar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amjad","family":"Tonbari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramadan","family":"Salem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8181-875X","authenticated-orcid":false,"given":"Colin","family":"Powell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"81","published-online":{"date-parts":[[2022,1,11]]},"reference":[{"unstructured":"British Thoracic Society , Scottish Intercollegiate Guidelines Network . SIGN158 British guideline on the management of asthma. Revised edition published July 2019. https:\/\/www.brit-thoracic.org.uk\/document-library\/guidelines\/asthma\/btssign-guideline-for-the-management-of-asthma-2019\/","key":"2024101704000653000_17.4.210113.1"},{"unstructured":"National Asthma Council Australia . Australian Asthma Handbook \u2013 Quick Reference Guide, Version 2.1. Melbourne, National Asthma Council Australia , 2020. www.asthmahandbook.org.au","key":"2024101704000653000_17.4.210113.2"},{"doi-asserted-by":"crossref","unstructured":"Trottier ED , Chan K , Allain D , et al .\u00a0Position statement: Managing an acute asthma exacerbation in children.\u00a0Canadian Paediatric Society,\u00a0\u00a02021. https:\/\/cps.ca\/en\/documents\/position\/managing-an-acute-asthma-exacerbation","key":"2024101704000653000_17.4.210113.3","DOI":"10.1093\/pch\/pxab058"},{"unstructured":"Global Initiative for Asthma. 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