Efficacy of Nebulized Magnesium Sulphate with Salbutamol versus Salbutamol Alone in Pediatric Patients with Moderate to Severe Asthma Exacerbations: A Comparative Cross-Sectional Study

Nebulized Magnesium Sulphate in Pediatric Asthma Exacerbations

Abstract

Acute asthma exacerbation is a leading cause of pediatric emergency. β2-agonists and systemic corticosteroids remain the cornerstone of management and necessitate adjunct therapies such as magnesium sulphate. Objective: To compare the efficacy of nebulized magnesium sulphate combined with salbutamol versus salbutamol alone in reducing asthma severity among pediatric patients presenting with moderate to severe asthma exacerbations. Method: This quasi‑experimental study was conducted in the Pediatrics Department at Sharif Medical City Hospital, Lahore. 60 children aged 2–15 years with moderate to severe asthma exacerbations were allocated to receive either nebulized salbutamol with magnesium sulphate (n=30) or salbutamol with placebo (n=30). Asthma severity was assessed using the Pediatric Respiratory Assessment Measure (PRAM) score at baseline, 60 minutes, and 120 minutes. Efficacy was defined as a reduction of at least 3 points in PRAM score at 120 minutes. Data were analyzed using SPSS version 28.0, with p ≤ 0.05 considered statistically significant. Results: Baseline characteristics and PRAM scores were comparable between groups (7.17 ± 2.17 vs. 8.03 ± 2.31; p>0.05). At 60 minutes, mean PRAM scores were significantly lower in the magnesium sulphate group (4.10 ± 2.80) compared to the placebo group (6.57 ± 2.74; p<0.05), with further improvement at 120 minutes (2.37 ± 3.18 vs. 5.20 ± 3.15; p<0.05). Conclusions: Nebulized magnesium sulphate is an effective and safe adjunct to salbutamol in the management of moderate to severe acute asthma exacerbations in children, particularly among younger age groups.