{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T01:45:12Z","timestamp":1773279912940,"version":"3.50.1"},"reference-count":15,"publisher":"The Pediatric Pharmacy Association","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Our objective was to compare doses of intravenous magnesium sulfate and their association with escalations in therapy in children and adolescents presenting to the emergency department with an asthma exacerbation.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n This was a retrospective cohort study among children who received both magnesium sulfate and standard of care therapy for asthma exacerbations. A classification and regression tree (CART) analysis was performed to identify a breakpoint in dose in which a difference in the primary outcome was present. The primary endpoint was need for escalation in therapy within 24 hours of initial magnesium sulfate dose, defined as need for invasive or non-invasive mechanical ventilation or need for adjunctive therapy, that is, epinephrine, terbutaline, aminophylline, theophylline, ketamine, heliox, or additional doses of magnesium sulfate.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n A total of 210 patients were included in the study. A CART analysis identified that a breakpoint of 27 mg\/kg of magnesium was associated with a difference in the primary outcome of escalation in therapy in patients <40 kg. A subgroup analysis of patients <40 kg (n = 149) found patients who received magnesium doses >27 mg\/kg had a higher incidence of the primary outcome of escalation in therapy, 15 patients (18.3%) versus 3 patients (4.5%) in the \u226427-mg\/kg\/dose group (p = 0.011).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Our results demonstrate larger doses of magnesium sulfate are associated with an increased need for invasive or non-invasive mechanical ventilation or need for adjunctive therapy(ies). Our findings are limited by confounding factors that may have influenced this outcome in our population.<\/jats:p>\n <\/jats:sec>","DOI":"10.5863\/1551-6776-25.4.314","type":"journal-article","created":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T20:51:05Z","timestamp":1589835065000},"page":"314-319","source":"Crossref","is-referenced-by-count":3,"title":["Escalation in Therapy Based on Intravenous Magnesium Sulfate Dosing in Pediatric Patients With Asthma Exacerbations"],"prefix":"10.5863","volume":"25","author":[{"given":"Christine A.","family":"Kapuscinski","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sierra D.","family":"Stauber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Hutchinson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"key":"i1551-6776-25-4-314-b1","series-title":"Guidelines for the Diagnosis and Management of Asthma (EPR-3)","unstructured":"Guidelines for the Diagnosis and Management of Asthma (EPR-3). https:\/\/www.nhlbi.nih.gov\/sites\/default\/files\/media\/docs\/asthgdln_1.pdf. Accessed March 2020."},{"key":"i1551-6776-25-4-314-b2","series-title":"Asthma Facts: CDC's National Asthma Control Program Grantees","unstructured":"Asthma Facts: CDC's National Asthma Control Program Grantees. https:\/\/www.cdc.gov\/asthma\/pdfs\/asthma_facts_program_grantees.pdf. Accessed March 2020."},{"issue":"2","key":"i1551-6776-25-4-314-b3","series-title":"J Pediatr Phamacol Ther","first-page":"91","article-title":"Use of intravenous magnesium sulfate for the treatment of asthma exacerbations in pediatric patients","volume":"19","year":"2014","unstructured":"Kokotajlo\n S\n , DegnanL, MeyersR, \n et al. Use of intravenous magnesium sulfate for the treatment of asthma exacerbations in pediatric patients. J Pediatr Phamacol Ther. 2014;19(2):91\u201397."},{"issue":"1","key":"i1551-6776-25-4-314-b4","series-title":"J Pediatr Pharmacol Ther","first-page":"40","article-title":"Magnesium sulfate for severe acute asthma in children","volume":"8","year":"2003","unstructured":"Kelly\n HW.\n \n \n Magnesium sulfate for severe acute asthma in children. J Pediatr Pharmacol Ther. 2003;8(1):40\u201345."},{"issue":"2","key":"i1551-6776-25-4-314-b5","series-title":"Cochrane Database Syst Rev","first-page":"CD001490","article-title":"Magnesium sulfate for treating exacerbations of acute asthma in the emergency department","year":"2000","unstructured":"Rowe\n BH\n , BretzlaffJ, BourdonC, \n et al. Magnesium sulfate for treating exacerbations of acute asthma in the emergency department. Cochrane Database Syst Rev. 2000;(2):CD001490."},{"issue":"3","key":"i1551-6776-25-4-314-b6","series-title":"Eur J Clin Pharmacol","first-page":"325","article-title":"Clinical pharmacokinetics of magnesium sulfate in the treatment of children with severe acute asthma","volume":"73","year":"2017","unstructured":"Rower\n JE\n , LiuX, YuT, \n et al. Clinical pharmacokinetics of magnesium sulfate in the treatment of children with severe acute asthma. Eur J Clin Pharmacol. 2017;73(3):325\u2013331."},{"issue":"8","key":"i1551-6776-25-4-314-b7","series-title":"JAMA","first-page":"1076","article-title":"Bronchodilating effect of intravenous magnesium sulfate in bronchial asthma","volume":"257","year":"1987","unstructured":"Okayama\n H\n , AikawaT, OkayamaM, \n et al. Bronchodilating effect of intravenous magnesium sulfate in bronchial asthma. JAMA. 1987;257(8):1076\u20131078."},{"issue":"9","key":"i1551-6776-25-4-314-b8","series-title":"JAMA","first-page":"1210","article-title":"Intravenous magnesium sulfate for the treatment of acute asthma in the emergency department","volume":"262","year":"1989","unstructured":"Skobeloff\n EM\n , SpiveyWH, McNamaraRM, GreensponL.\n Intravenous magnesium sulfate for the treatment of acute asthma in the emergency department. JAMA. 1989;262(9):1210\u20131213."},{"issue":"6","key":"i1551-6776-25-4-314-b9","series-title":"Pediatr Emerg Care","first-page":"390","article-title":"Intravenous and nebulized magnesium sulfate for treating acute asthma in children","volume":"34","year":"2018","unstructured":"Su\n Z\n , LiR, GaiZ.\n Intravenous and nebulized magnesium sulfate for treating acute asthma in children. Pediatr Emerg Care. 2018;34(6):390\u2013395."},{"issue":"2","key":"i1551-6776-25-4-314-b10","series-title":"Indian Pediatr","first-page":"128","article-title":"Systematic review on efficacy of magnesium (intravenous or nebulized) for acute asthma episodes in children","volume":"54","year":"2017","unstructured":"Saha\n A.\n \n \n Systematic review on efficacy of magnesium (intravenous or nebulized) for acute asthma episodes in children. Indian Pediatr. 2017;54(2):128\u2013131."},{"issue":"2","key":"i1551-6776-25-4-314-b11","series-title":"Pediatr Crit Care Med","first-page":"e29","article-title":"High-dose magnesium sulfate infusion for severe asthma in the emergency department: efficacy study","volume":"17","year":"2016","unstructured":"Irazuzta\n JE\n , ParedesF, PavlicichV, DominquezSL.\n High-dose magnesium sulfate infusion for severe asthma in the emergency department: efficacy study. Pediatr Crit Care Med. 2016;17(2):e29\u2013e33."},{"key":"i1551-6776-25-4-314-b12","series-title":"Pediatric and Neonatal Dosage Handbook","year":"2015","unstructured":"Taketomo\n CK\n , HoddingJH, KrausDM.\n Pediatric and Neonatal Dosage Handbook. 22nd ed. Hudson, OH: Wolters Kluwer; 2015."},{"issue":"18","key":"i1551-6776-25-4-314-b13","series-title":"Arch Intern Med","first-page":"2741","article-title":"Effects of computerized physician order entry on prescribing practices","volume":"160","year":"2000","unstructured":"Teich\n JM\n , MerchiaPR, SchmizJL, \n et al. Effects of computerized physician order entry on prescribing practices. Arch Intern Med. 2000;160(18):2741\u20132747."},{"issue":"4","key":"i1551-6776-25-4-314-b14","series-title":"Arch Argent Pediatr","first-page":"291","article-title":"Effectiveness of magnesium sulfate as initial treatment of acute severe asthma in children, conducted in a tertiary-level university hospital: a randomized, controlled trial","volume":"110","year":"2012","unstructured":"Torres\n S\n , SticcoN, BoschJJ, \n et al. Effectiveness of magnesium sulfate as initial treatment of acute severe asthma in children, conducted in a tertiary-level university hospital: a randomized, controlled trial. Arch Argent Pediatr. 2012;110(4):291\u2013296."},{"issue":"3","key":"i1551-6776-25-4-314-b15","series-title":"Ann Emerg Med","first-page":"181","article-title":"Intravenous magnesium sulfate treatment for acute asthma in the emergency department: a systematic review of the literature","volume":"36","year":"2000","unstructured":"Rowe\n BH\n , BretzlaffJA, BourdonC, \n et al. Intravenous magnesium sulfate treatment for acute asthma in the emergency department: a systematic review of the literature. Ann Emerg Med. 2000;36(3):181\u2013190."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/25\/4\/article-p314.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/jppt\/article-pdf\/25\/4\/314\/2564360\/1551-6776-25_4_314.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/25\/4\/article-p314.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/25\/4\/article-p314.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:38:41Z","timestamp":1747355921000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/25\/4\/article-p314.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020]]},"references-count":15,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-25.4.314","relation":{},"ISSN":["1551-6776"],"issn-type":[{"value":"1551-6776","type":"print"}],"subject":[],"published":{"date-parts":[[2020]]}}}