Intravenous magnesium sulphate in children with acute wheeze: a nationwide survey.

Objective: Dutch guidelines recommend to consider intravenous magnesium sulfate (iv MgSO) as a treatment option in case of failure of first line treatment in both children with exacerbations of acute episodic viral wheeze (AEVW) and acute asthma (AA). The implications on the actual use of iv MgSO iv in daily practice in both groups are unknown. Therefore, we conducted a cross-sectional nationwide survey to evaluate the use of iv MgSO in children with AEVW and AA.

Methods: A questionnaire was handed out to pediatricians and pediatric residents in one academic and six community teaching hospitals.

Results: In 111 respondents, 76% reported regular use of iv MgSO in children with AEVW and 96% in children with AA. In total 89% and 93% of users were convinced iv MgSO was effective in children with AEVW and AA, respectively. Adverse effects, mainly hypotension, were identified by 23% and 17% of users in AEVW and AA, respectively. Most common reasons not to give MgSO were lack of evidence and small amount of studies.

Conclusions: IV MgSO is reported to be widely used in Dutch practice in both young children with AEVW and older children with AA by respondents, while the national guidelines advise only to consider this treatment option.