1.Efficacy and safety of magnesium sulfate in the treatment of adult patients with acute severe asthma: a Meta-analysis.
Zhimei ZHONG ; Zengrui WANG ; Sheng QI ; Chaoqian LI ; Xia YANG
Chinese Critical Care Medicine 2024;36(12):1256-1260
OBJECTIVE:
To evaluate the efficacy and safety of magnesium sulfate in the treatment of acute severe asthma in adults.
METHODS:
Literature searches were conducted on PubMed, Cochrane, CNKI, VIP and Wanfang databases to screen randomized controlled trial (RCT) of magnesium sulfate in the treatment of acute severe asthma in adults, starting from the establishment of the database and ending on May 22, 2024. The control group received conventional treatment. The observation group was given intravenous magnesium sulfate on the basis of routine treatment. The outcome indexes included total effective rate, peak expiratory flow (PEF), forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and other pulmonary function indexes, and incidence of adverse reactions. The selection of relevant literature, the collection of data needed for the study and the risk assessment of bias in the included study were all conducted independently by 2 researchers. Stata 12.0 software was used for Meta-analysis, and funnel plot was used to evaluate publication bias.
RESULTS:
Sixteen RCT studies with a total of 2 601 patients were included. Meta-analysis results showed that the total effective rate in the observation group was significantly higher than that in the control group [risk ratio (RR) = 1.11, 95% confidence interval (95%CI) was 1.03-1.20, P = 0.008]. In pulmonary function examination, PEF [weighted mean difference (WMD) = 0.70, 95%CI was 0.24-1.15, P = 0.003], FEV1 (WMD = 0.48, 95%CI was 0.29-0.68, P = 0.000) and FVC (WMD = 0.72, 95%CI was 0.47-0.97, P = 0.000) were significantly better than those in the control group. There was no significantly difference in the incidence of adverse reactions between the two groups (RR = 0.51, 95%CI was 0.17-1.55, P = 0.419). The funnel plot was drawn for the total effective rate, which showed that each study presented a symmetrical distribution, and the Begg's test (Z = 1.31, P = 0.189) and Egger's test (t = 1.18, P = 0.261) were combined to consider the small possibility of publication bias.
CONCLUSIONS
Current evidence shows that the use of magnesium sulfate in the treatment of acute severe asthma in adults increases the total response rate and improves lung function without increasing the incidence of adverse reactions. Due to the limited number and quality of included studies, the above conclusions need to be verified by more high-quality studies high-quality studies.
Humans
;
Magnesium Sulfate/administration & dosage*
;
Asthma/drug therapy*
;
Adult
;
Randomized Controlled Trials as Topic
;
Forced Expiratory Volume
;
Peak Expiratory Flow Rate/drug effects*
;
Treatment Outcome
2.Effect of Magnesium Sulfate, Nifedipine Tablet Combined Salvia Injection on ET-1/NO, TXA2/PGI2 and Hemorheology of Preeclampsia Patients.
Xiao-ying ZHENG ; Jing YAO ; Jia-mei ZHU ; Mei LI ; Shu-qiong QIU ; Zhao-xia ZHU ; Ming ZHANG
Chinese Journal of Integrated Traditional and Western Medicine 2015;35(8):962-965
OBJECTIVETo observe the effect of magnesium sulfate, Nifedipine Tablet (NT) combined Salvia Injection (SI) on endothelin-1 (ET-1), nitric oxide (NO), thromboxane A2(TXA2), prostacyclin I2(PG2), and hemorheology of preeclampsia patients.
METHODSTotally 704 preeclampsia patients were randomly assigned to the treatment group and the control group, 352 cases in each group. All patients were treated with magnesium sulfate combined NT (on the first day: slow intravenous injection of magnesium sulfate 5 g + intravenous dripping of magnesium sulfate injection 10 g + oral administration of NT 30 mg; on the second and third day, intravenous dripping of magnesium sulfate injection 10 g + oral administration of NT 30 mg), while those in the treatment group were dripped with SI additionally at 20 mL per day for 3 consecutive days. Before and after treatment plasma levels of endothelin-1 (ET-1), nitric oxide (NO), TXA2, PGi2, and hemorheology indicators [such as high blood viscosity (HBV), low blood viscosity (LBV), plasma viscosity (PV), erythrocyte rigidity index (ERI), fibrinogen (FIB)] of two groups were detected.
RESULTSCompared with the same group before treatment, serum levels of ET-1, TXA2, HBV, LBV, PV, ERI, and FIB decreased in the two groups after treatment (P <0. 05), but levels of NO and PG2 increased (P <0. 05). Compared with the control group in the same period, levels of ET-1, TXA2, HBV, LBV, PV, ERI, and FIB decreased in the treatment group after treatment (P <0. 05), but levels of NO and PGI2 increased (P <0. 05).
CONCLUSIONMagnesium sulfate, NT combined SI could effectively regulate the balance of ET-1/NO and TXA2/PGI2, and improve hemorheology of preeclampsia patients.
Drug Therapy, Combination ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Endothelin-1 ; metabolism ; Epoprostenol ; metabolism ; Female ; Hemorheology ; Humans ; Injections ; Magnesium Sulfate ; administration & dosage ; pharmacology ; therapeutic use ; Nifedipine ; administration & dosage ; pharmacology ; therapeutic use ; Nitric Oxide ; metabolism ; Pre-Eclampsia ; drug therapy ; Pregnancy ; Salvia ; Tablets ; Thromboxane A2 ; metabolism
3.Clinical re-evaluation of effects of two different "cocktail therapy" to prevent from phlebitis induced by Chansu injection.
Yu-Bin ZHAO ; Zhe HAO ; Hong-Dan ZHANG ; Yan-Ming XIE
China Journal of Chinese Materia Medica 2012;37(18):2739-2741
OBJECTIVETo re-evaluate the effects of different "cocktail therapy" to prevent from phlebitis induced by Chansu injection.
METHODPatients treated with Chansu injection were divided randomLy into 4 groups with 90 per group, control group, phentolaminum group, the magnesium sulfate group-phentolaminum group, and anisodamine-phentolaminum group. Patients in the control group only received the routine nursing treatment, and patients in the various experiment group received different interventions. The comparison was made in the morbidity and the starting time of occurrence of phlebitis, the severity of pain, duration of pain.
RESULTThe morbidity of phlebitis was 8%, 8%, 6%, respectively. The starting time of phlebitis occurrence was (22 +/- 4), (27 +/- 5), (28 +/- 7) h, respectively. The NRS of pain was (4.75 +/- 1.51), (3.27 +/- 1.02), (2.71 +/- 1.63), respectively. The duration time of pain was (4.25 +/- 1.36), (2.51 +/- 1.05), (2.19 +/- 1.13) d respectively. In control group, the morbidity of phlebitis, the starting time of occurrence of phlebitis, the severity of pain, duration of pain was 30%, (16 +/- 4) h, (6.34 +/- 1.21), (5.47 +/- 1.07) d, respectively. As compared with the control group, a significance difference was found between every group in three test groups and control group respectively (P<0.05).
CONCLUSIONThe morbidity and the starting time of occurrence of phlebitis, the severity of pain, duration of pain was significantly reduced respectively by two different "cocktail therapy".
Adult ; Aged ; Animals ; Anura ; Bufanolides ; administration & dosage ; adverse effects ; Drug Therapy, Combination ; Humans ; Magnesium Sulfate ; therapeutic use ; Male ; Middle Aged ; Phentolamine ; therapeutic use ; Phlebitis ; drug therapy ; etiology ; prevention & control ; Solanaceous Alkaloids ; therapeutic use ; Young Adult
4.Clinical re-evaluation of effects of different treatments to prevent from phlebitis induced by Chansu injection.
Yubin ZHAO ; Zhe HAO ; Hongdan ZHANG ; Jian SHI ; Yanming XIE
China Journal of Chinese Materia Medica 2011;36(20):2803-2806
OBJECTIVETo re-evaluate the effects of different treatments to prevent from phlebitis induced by Chansu injection.
METHODPatients treated with Chansu injection were divided randomly into 4 groups with 50 per group, control group, the magnesium sulfate group, phentolaminum group, and anisodamine group. Patients in the control group only received the routine nursing treatment, and patients in the various experiment group received different interventions. The comparison was made in the morbidity and the starting time of occurrence of phlebitis, the severity of pain, duration of pain.
RESULTThe morbidity of phlebitis was 8%, 8%, 6% respectively. The starting time of phlebitis occurrence was (21 +/- 9.31) , (22.34 +/- 10.15), (20.19 +/- 11.23) h, respectively. The NRS of pain was (4. 15 +/- 1.03), (3.26 +/- 1.17), (4.32 +/- 1.36), respectively. The duration time of pain was (4.05 +/- 1.21), (3.37 +/- 1.17), (3.19 +/- 1.67) d, respectively. In control group, the morbidity of phlebitis, the starting time of occurrence of phlebitis, the severity of pain, duration of pain was 24%, (17 +/- 6.32) h, (6.58 +/- 1.29), (5.32 +/- 1.12) d, respectively. As compared with the control group, a significance difference was found between every group in three test groups and control group respectively (P<0.05).
CONCLUSIONThe morbidity and the starting time of occurrence of phlebitis, the severity of pain, duration of pain was significantly reduced respectively by external appication of magnesium sulfate, anisodamine, and intravenous drip infusion of phentolaminum.
Adult ; Aged ; Aged, 80 and over ; Bufanolides ; adverse effects ; Female ; Humans ; Infusions, Intravenous ; Magnesium Sulfate ; therapeutic use ; Male ; Middle Aged ; Morbidity ; Phentolamine ; administration & dosage ; Phlebitis ; chemically induced ; prevention & control ; Solanaceous Alkaloids ; therapeutic use ; Time Factors
5.Assessment of the protective effect of calcium-magnesium infusion and glutathione on oxaliplatin-induced neurotoxicity.
Mei DONG ; Pu-yuan XING ; Peng LIU ; Feng-yi FENG ; Yuan-kai SHI
Chinese Journal of Oncology 2010;32(3):208-211
OBJECTIVETo assess the efficacy of calcium-magnesium (Ca/Mg) infusion and glutathione (GSH) for preventing the neurotoxicity induced by oxaliplatin.
METHODSThis is a randomized, double blind, placebo controlled clinical trail. The patients receiving FOLFOX4 chemotherapy for their solid tumor were randomized to receive Ca/Mg, GSH or normal saline with chemotherapy simultaneously. The incidence and severity of oxaliplatin-induced neurotoxicity were observed. The ECOG performance status was recorded and compared among the 3 groups.
RESULTSNinety-three patients admitted in our department from Mar 2006 to Dec 2007 were entered into this study, including 29 patients in the Ca/Mg group, 33 in the GSH group and 31 in the chemotherapy alone group. The incidences of acute neurotoxicity were 82.8%, 90.9% and 93.5%, respectively. At the third cycle, the incidences of grade 1-2 chronic neurotoxicity were 37.9%, 48.5% and 42.0%, respectively. No grade 3 neuropathy was observed. After 6 cycles, the incidence of grade 1-2 neuropathy was increased to 68.2%, 88.9% and 85.2%, respectively. A lower percentage was observed in Ca/Mg arm without a statistically significant difference, and grade 3 neuropathy occurred in 5 patients. After 9 cycles, the incidence of grade 1-2 neuropathy was increased to 81.3%, 90.0% and 92.9%, respectively. Grade 3 neuropathy occurred in another 2 patients. No statistically significant difference was observed among the 3 arms. Changes of patient's ECOG score after chemotherapy were similar.
CONCLUSIONThis study didn't provide evidence that Ca/Mg infusion and GSH can prevent the oxaliplatin-induced neurotoxicity.
Adolescent ; Adult ; Aged ; Anticonvulsants ; administration & dosage ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Calcium Gluconate ; administration & dosage ; Colorectal Neoplasms ; drug therapy ; Double-Blind Method ; Drug Therapy, Combination ; Female ; Fluorouracil ; adverse effects ; therapeutic use ; Glutathione ; therapeutic use ; Humans ; Infusions, Intravenous ; Leucovorin ; adverse effects ; therapeutic use ; Magnesium Sulfate ; administration & dosage ; Male ; Middle Aged ; Neurotoxicity Syndromes ; etiology ; prevention & control ; Organoplatinum Compounds ; adverse effects ; therapeutic use ; Stomach Neoplasms ; drug therapy ; Young Adult
6.Effect of the mixed liquor of danshen and magnesium sulfate injection on IgG and IgM in serum of rabbits with lumbar intervertebral disc herniation.
Zhi-bin LI ; Pu-wei YUAN ; Chao ZHU
China Journal of Orthopaedics and Traumatology 2009;22(10):773-775
OBJECTIVETo explore the effect of the mixed liquor of danshen and magnesium sulfate injection on inflammatory reaction caused by autoimmune response of rabbits with lumbar intervertebral disc herniation.
METHODSSixty rabbits were divided into blank group (10 rabbits), sham operation group (10 rabbits), model group (40 rabbits) according to method of random digits table. Then model group was divided into made group (group A, 10 rabbits), normal saline group (group B, 10 rabbits), aescin natrium group (group C, 10 rabbits) and danshen and magnesium sulfate injection group (group D,10 rabbits). After model success of lumbar intervertebral disc herniation, different drugs were given to rabbits with lumbar intervertebral disc herniation by ear margin vein. The rabbits of the group C,B,D were respectively given aescin natriu (0.5 mg/kg), normal saline (5 ml/kg), danshen and magnesium sulfate injection (2.0 mg/kg). The rabbits of blank group, sham operation group and group A were not given any disposal. The IgG and IgM level in serum of different groups were determined with ELISA method in fourteen day after model success and drugs given.
RESULTSThe level of IgG and IgM in the group A was higher than that of blank group and sham operation group (P < 0.05). The level of IgG and IgM in the group D was lower than that of group B,C (P < 0.05).
CONCLUSIONThe mixed liquor of danshen () and magnesium sulfate injection could inhibit inflammatory reaction caused by autoimmune response of lumbar intervertebral disc herniation,which provides a new alternative for lumbar intervertebral disc herniation.
Animals ; Disease Models, Animal ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Injections ; Intervertebral Disc Displacement ; blood ; drug therapy ; immunology ; Magnesium Sulfate ; administration & dosage ; Male ; Phenanthrolines ; administration & dosage ; Rabbits ; Random Allocation ; Salvia miltiorrhiza ; chemistry
7.Comparison of different vehicles for nebulized salbutamol in treatment of bronchial asthma exacerbations: a Meta-analysis.
Journal of Zhejiang University. Medical sciences 2006;35(3):336-341
OBJECTIVETo assess the efficacy of two vehicles for nebulized salbutamol in treatment of asthma exacerbations with Meta-analysis.
METHODSAll relevant randomized controlled clinical trials (RCT) with isotonic magnesium sulphate and saline as vehicles for inhaled salbutamol in treatment of asthma exacerbations were searched. A Meta-analysis was performed to evaluate the results of the two therapies.
RESULTFive relevant RCTs from literature were collected and total 219 cases were included for analysis. The meta-analysis indicated that the significant improvements were obtained from isotonic magnesium sulphate as a vehicle for nebulized salbutamol, in comparison with saline [pooled standardized mean difference (SMD)=0.55(95% CI 0.28 - 0.83), P <0.001]. By further subgroup analysis, this change was properly significant in the subgroup of severe patients with their baseline FEV1% <30% [FEV1 weighted mean difference (WMD)=0.72 L(95% CI 0.30 L - 1.14 L), P <0.01]. The pooled results of vital signs between two vehicles did not demonstrate statistical significance. Overall, the risk of admission to hospital was not statistically reduced in patients using magnesium sulphate, who presented to the emergency department with an asthma exacerbation [pooled RR=0.64(95% CI 0.38 - 1.08), P >0.05].
CONCLUSIONCompared with saline,the use of isotonic magnesium sulfate as an adjuvant to nebulize salbutamol is a beneficial therapy with improving spirometric airway function in the severe asthma exacerbation.
Adrenergic beta-Agonists ; administration & dosage ; Albuterol ; administration & dosage ; Asthma ; drug therapy ; Female ; Humans ; Magnesium Sulfate ; administration & dosage ; Male ; Nebulizers and Vaporizers ; Pharmaceutical Vehicles ; Randomized Controlled Trials as Topic
8.One-day bowel preparation with sodium phosphate prior to colorectal surgery: a prospective, randomized, controlled clinical trial.
Xin LU ; Yi-lei MAO ; Xin-ting SANG ; Zhi-ying YANG ; Shou-xian ZHONG ; Jie-fu HUANG
Chinese Journal of Surgery 2006;44(19):1327-1329
OBJECTIVESTo investigate the feasibility and safety of one-day bowel preparation for colorectal surgery.
METHODSForty patients undergone colorectal surgery were divided randomly into the Control group and the Experimental group and received 3-day magnesium sulfate and 1-day sodium phosphate bowel preparations before the operation, respectively. The levels of hemoglobin, hematocrit, serum electrolytes, and anaerobe counts in the stool prior and post bowel preparation were examined. The general status, surgical complications, and structure of intestinal mucosa in the patients were observed after the operation.
RESULTSThere was no significant difference in the anastomoses healing, infectious complications, serum tests and intestinal mucosa structures between the two groups. Less diarrhea occurred prior and post the surgery in the experimental group, and they felt better with the bowel preparation. The anaerobe counts in stool were higher after the bowel preparation than before in both groups.
CONCLUSIONSOne-day bowel preparation with sodium phosphate is a safe and reliable method for colorectal surgery. The shortening of preparation time can reduce the degrees of uncomfortable feeling and disruptions of intestinal micro-ecology and barrier.
Colorectal Neoplasms ; surgery ; Enema ; Humans ; Intestinal Mucosa ; drug effects ; microbiology ; Magnesium Sulfate ; administration & dosage ; Middle Aged ; Phosphates ; administration & dosage ; Postoperative Complications ; Preoperative Care ; methods ; Prospective Studies
9.Accidental Intravenous Administration of Magnesium Sulfate during Cesarean Section: A case report.
Tae Kwan KIM ; Yee Suk KIM ; Jun Roh YOON ; In Soo HAN ; Ho Sik MOON ; Jin Seo KIM
Korean Journal of Anesthesiology 2003;45(5):656-660
We report a case of the accidental intravenous administration of a large dose of magnesium sulfate during cesarean section. A 41-year-old woman, at 33 weeks gestation, with pregnancy-aggravated hypertension, headache and generalized edema presented in acute labor and showed fetal bradycardia on a nonstress test. Laboratory tests demonstrated an increased level of magnesium (5.4 mg/dl). A cesarean section was performed under general anesthesia with O2-N2O-enflurane and vecuronium. After delivery 2,000 mg of magnesium sulfate was mixed with the lactated Ringer's solution 1,000 ml and 550 ml administered to the patient. After noticing the accidental infusion of the magnesium sulfate, we replaced the lactated Ringer's solution with normal saline 1,000 ml and performed arterial blood gas analysis, checked serum electrolyte, including Mg2+ and Ca2+, and had monitored depth of muscle relaxation and vital signs. The level of magnesium had increased to 8.9 mg/dl after the accidental magnesium infusion. For about one and half hours after emergence from general anesthesia, she complained of dyspnea and paraparesis of extremities. To treat the hypermagnesemia, 3% calcium gluconate 1,000 mg and furocemide were given intravenously to antagonize magnesium and to increase the urine output. The depth of neuromuscular block was frequently monitored using a nerve stimulator. After conservative treatment, she recovered from the effect of the hypermagnesemia and was discharged on the fifth postoperative day. Anesthesiologists must to keep in mind the preoperative patients' pathophysiologic conditions, check co-administered drugs and the contents of intravenously connected solutions.
Administration, Intravenous*
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Adult
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Anesthesia, General
;
Blood Gas Analysis
;
Bradycardia
;
Calcium Gluconate
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Cesarean Section*
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Dyspnea
;
Edema
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Extremities
;
Female
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Headache
;
Humans
;
Hypertension
;
Magnesium Sulfate*
;
Magnesium*
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Muscle Relaxation
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Neuromuscular Blockade
;
Paraparesis
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Pre-Eclampsia
;
Pregnancy
;
Vecuronium Bromide
;
Vital Signs

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