Nebulized Magnesium Sulfate has been shown to be of benefit in adults with acute asthma
exacerbations, though limited work has been done in the pediatric population. Current
therapeutic questions include the effect of more than one dose of nebulized magnesium, the
possibility of a sustained effect (greater than 20 minutes) after a treatment, the potential
benefit in children younger than 5 years of age, and the use of an asthma score to re-assess
patients after treatment with this medication. The purpose of this double-blind randomized
placebo-controlled clinical trial is the evaluate the effect of multiple doses of nebulized
magnesium sulfate versus saline in addition to standard asthma therapy on clinical asthma
score and FEV1 in children 7 to 18 years of age with a moderate to severe acute asthma
exacerbation. Our hypothesis is that nebulized magnesium sulfate, when added to traditional
bronchodilator therapy, will improve acute asthma exacerbations more rapidly than standard
therapy alone. The primary outcomes are asthma score and FEV1 values obtained after two
nebulized magnesium sulfate compared to placebo treatments. This therapy will be supplemental
to standard therapy of albuterol and ipratropium nebulized treatments and systemic
corticosteroids. The secondary outcome is patient disposition (discharge home or
hospitalization). Patients with known asthma will be approached for enrollment and informed
consent obtained if the asthma score after the first albuterol treatment is "2" or greater.
One hundred-seventy patients will be enrolled and randomized to either the treatment group or
the placebo group. The change from baseline in asthma scores and FEV1 values will be compared
among the control and treatment groups to assess for any benefit of the addition of nebulized
magnesium sulfate to the treatment regimen.