{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T06:26:56Z","timestamp":1786688816430,"version":"build-2736575974"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to conduct an umbrella review comparing intravenous versus nebulized magnesium sulfate for acute asthma exacerbations, providing evidence to guide route selection and clinical decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP, WANFANG, and CBM from inception to August 2025, for systematic reviews\/meta analyses comparing intravenous versus nebulized magnesium sulfate for acute asthma exacerbations. Overlap among primary studies was assessed using a citation matrix and corrected covered area. Quality assessment was performed using ROBIS, AMSTAR-2, PRISMA 2020, and GRADE. Quantitative and qualitative analyses of primary outcomes were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 18 systematic reviews\/meta analyses were included. The corrected covered area was 5.168%, indicating some overlap in primary studies. ROBIS judged all studies at low risk of bias. AMSTAR-2 rated 6 studies as high quality, 2 as moderate, and 10 as low. PRISMA 2020 scores ranged from 25.5 to 41, with 10 studies of high and 8 of moderate reporting quality. GRADE yielded 13 high-quality, 38 moderate-quality, 27 low-quality, and 26 extremely low-quality outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This overview clarifies the role of intravenous magnesium sulfate in acute asthma: not for routine use but as secondary adjunctive therapy for severe cases refractory to first-line treatment. The role of nebulized magnesium sulfate is more complex\u2014neither universally applicable nor a replacement for first-line medications. Current evidence does not support routine use, warranting only a weak recommendation for patients who fail standard therapy. Future research should focus on its synergistic effects with other therapies and further elucidate its mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:ext-link>\n                      , PROSPERO: CRD420251122150.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1917060","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T05:31:57Z","timestamp":1786685517000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative efficacy and safety of intravenous versus nebulized magnesium sulfate for acute asthma exacerbations: an overview of systematic reviews and meta-analyses"],"prefix":"10.3389","volume":"13","author":[{"given":"Yongji","family":"Wang","sequence":"first","affiliation":[{"name":"College of Traditional Chinese Medicine, Changchun University of Chinese Medicine","place":["Changchun, Jilin, China"]},{"name":"Department of Pediatric Internal Medicine One, Affiliated Hospital of Changchun University of Chinese Medicine","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuang","family":"Wang","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine, Changchun University of Chinese Medicine","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengtao","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Pediatric Internal Medicine One, Affiliated Hospital of Changchun University of Chinese Medicine","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijie","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Pediatric Internal Medicine One, Affiliated Hospital of Changchun University of Chinese Medicine","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Tian","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine, Changchun University of Chinese Medicine","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofei","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Pediatric Internal Medicine One, Affiliated Hospital of Changchun University of Chinese Medicine","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongfu","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Pediatric Internal Medicine One, Affiliated Hospital of Changchun University of Chinese Medicine","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shulei","family":"Liu","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine, Changchun University of Chinese Medicine","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine, Changchun University of Chinese Medicine","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.jaip.2022.10.031","article-title":"Asthma management in children","volume":"11","author":"Shipp","year":"2023","journal-title":"J Allergy Clin Immunol 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