3. Summary of Interventions.
| Study (N) | Magnesium sulfate | Control | ||||
| Dose | N | Co‐interventions | Dose | N | Co‐interventions | |
| MgSO₄ and SABA and Ipratropium bromide versus SABA and Ipratropium | ||||||
| Ashtekar 2008 | 2.5 mL isotonic MgSO₄ (151 mg /dose) | 7 | 500 mcg Ipratropium bromide 2.5 mg salbutamol or 5 mg salbutamol (depending on age) 3 times per h |
2.5 mL of isotonic saline) | 10 | Same as for MgSO₄ group |
| Drobina 2006 | 150 mg MgSO₄ (0.3 mL of 50% MgSO₄ heptahydrate) | 60 | Albuterol sulfate (0.5%) 5 mg/mL) and 0.5 mg ipratropium bromide (0.02% inhalation solution) (frequency*) | No placebo so volume will be less: i.e. blinding may be an issue) | 50 | Same as for MgSO₄ group |
| Gallegos‐Solórzano 2010 | 3 mL (333 mg) of 10% isotonic MgSO₄ (1 g/10 mL) | 60 (30 withdrawals) | 2.5 mg albuterol and 500 mcg ipratropium 3 doses per hour | 3 mL isotonic saline | 52 (22 withdrawals) | Same as for MgSO₄ group |
| Gaur 2008 | 3 mL (3.2 g%) isotonic MgSO₄ |
30 | Salbutamol and ipratropium (dose*, frequency*) | Saline | 30 | Same as for MgSO₄ group |
| Goodacre 2013 | 2 mmol MgSO₄ | 339 (7 withdrawal) | 7.5 mL 0.9% NaCl nebulised, 3 doses; 100 mL 0.9% NaCl IV once, BTS/SIGN standard treatments plus others at clinicians' discretion | 7.5 mL 0.9% saline nebulised, 3 doses, 100 mL 0.9% NaCl IV once | 364 (7 withdrawal) | BTS/SIGN standard treatments plus others at clinicians' discretion |
| Hossein 2016 | 3 mL (260 mmol/L) MgSO4 | 25 | 2.5 mg salbutamol, 0.5 mg ipratropium nebulised every 20 to 60 minutes, 50 mg oral prednisolone (once*) | 3 mL 0.9% NaCl | 25 | Same as for MgSO₄ group |
| Powell 2013 | 2.5 mL 250 mmol/L MgSO₄ | 252 (13 withdrawals) | 3 doses every 20 min. Hospital‐defined conventional treatment | 2.5 mL isotonic saline | 256 (10 withdrawals) | Same as for MgSO₄ group |
| MgSO4 and SABA versus SABA | ||||||
| Abreu‐Gonzalez 2002 | 2 mL MgSO₄ (isotonic) | 13 | 400 mcg salbutamol (once*) |
2 mL of a physiological serum of an inhaled form 11 patients |
11 | 400 mcg salbutamol |
| Aggarwal 2006 | 1 mL of 500 mg/mL MgSO₄ | 50 | 1 mL salbutamol (dose*, 8 mL distilled water, (295 mOsml/kg) 3 times per h ultrasonic nebuliser |
7.5 mL normal saline | 50 | 1 mL salbutamol (dose*), 1.5 mL distilled water (287 mOsml/kg) 3 times per h |
| Ahmed 2013 | MgSO₄ (dose* frequency*) | 60 | Not recorded | Normal saline (dose* frequency*) | 60 | Not recorded |
| Alansari 2015 | 800 mg (15 mL) MgSO₄ | 208 (17 withdrawals) | 5 mg albuterol, divided into 3 doses over 1 h. Methylprednisolone 1 mg/kg IV every 12 h. 3 doses nebulized 1 mL albuterol (5 mg/mL), 250 mcg ipratropium, 2 mL normal saline before trial doses started | 15 mL 0.9% NaCl | 192 (18 withdrawals) | Same as for MgSO₄ group |
| Badawy 2014 | 500 mg (1mL) MgSO₄ | 30 | 1 mL salbutamol solution (dose*), 8 mL 0.9% NaCl, max 3 doses with 20 mins apart. 100 mg hydrocortisone IV, 500 mg aminophylline IV (once*) | 1 mL 0.9% NaCl | 30 | Same as for MgSO₄ group |
| Bessmertny 2002 | MgSO₄ (384 mg) | 37 (3 withdrawals) | Followed by ( i.e. not mixed) albuterol 2.5 mg/mL 3 times per h | Normal saline (no volume documented) | 37 (3 withdrawals) | Same as for MgSO₄ group |
| Dadhich 2005 | MgSO₄ | 26 | No doses in any group or co‐interventions described | Not stated | 24 | No doses in any group or co‐interventions described |
| Hughes 2003 | 2.5 mL isotonic MgSO₄ (250 mmol/L 151 mg) 28 patients |
28 | 2.5 mg salbutamol 3 times per 30 minutes |
2.5 mL normal saline | 24 | Same as for MgSO₄ group |
| Khashabi 2008 | Isotonic MgSO₄ (dose*, frequency*) |
* | Salbutamol (dose*) | 2.5 mL normal saline (frequency*) | * | Same as for MgSO₄ group |
| Kokturk 2005 | Isotonic MgSO₄ (2.5 mL) | 14 | Salbutamol (dose*) 3 times per h then 1 per h for 3 h |
2.5 mL normal saline | 12 | Same as for MgSO₄ group |
| Mohammedzadeh 2014 | 3 mL 7.5% MgSO₄ | 40 | 0.15 mg/kg salbutamol 3 doses, every 20 min | 3 mL normal saline | 40 | Same as for MgSO₄ group |
| Mahajan 2004 | 2.5 mL Isotonic (6.3%) MgSO₄ solution | 31 | Albuterol 2.5 mg 1 dose | 2.5 mL normal saline | 31 | Same as for MgSO₄ group |
| Nannini 2000 | 3 mL isotonic MgSO₄ (286 mOsml, 7.5%, 225 mg) |
19 | 0.5 mL 2.5 mg salbutamol 1 dose* |
3 mL normal saline | 16 | Same as for MgSO₄ group |
| Sarhan 2016 | 2.5 mL MgSO4 (100 mg), 0.5 mL salbutamol (2.5 mg) | 10 | 4 doses at 20 min intervals. If needed: additional nebulised salbutamol, IV hydrocortisone, IV aminophylline | 2.5 mL isotonic saline | 10 | Same as for MgSO4 group |
| Turker 2017 | 1 mL magnesium sulfate (15%) + 1.5 mL isotonic saline | 50 | 3 doses at 20 min intervals. Also nebulised salbutamol (0.15 mg/kg), methylprednisolone 1 mg/kg IV; Oxygen was given to patients with SaO2 ≤ 95% | 1.5 mL isotonic saline | 50 | Same as for MgSO₄ group |
| MgSO₄ versus SABA | ||||||
| Dadhich 2005 | MgSO₄ | 21 | No doses in any group or co‐interventions described | Not stated | 24 | No doses in any group or co‐interventions described |
| Mangat 1998 | 3.2% solution MgSO₄ = 95 mg) | 16 | 4 doses every 20 minutes | 3 mL (2.5 mg) salbutamol | 17 | Four doses every 20 minutes |
| Meral 1996 | 2 mL MgSO₄ (280 mmol/L) | 20 | 1* dose given over 10 to 15 minutes | Salbutamol 2.5 mg in 2.5 mL | 20 | 1 dose* given over 10 to 15 minutes |
| Neki 2006 | 20 patients 3.2 G % MgSO₄ |
20 | 4 doses every 20 min | 3 mL of 25 mg* salbutamol (likely decimal point missing) | 20 | Same as for MgSO4 group |
| Sarhan 2016 | 3 mL (100 mg) MgSO4 | 10 | 4 doses at 20 min intervals. If needed: additional nebulised salbutamol, IV hydrocortisone, IV aminophylline | 0.5 mL salbutamol (2.5 mg) | 10 | Same as for MgSO₄ group |
| TOTAL: 2907 randomised to comparisons of interest. 130 withdrawn, 2777 completed | TOTAL: 1476 randomised, 70 withdrawn = 1406 completed intervention | TOTAL: 1431 randomised, 60 withdrawn = 1371 completed control | ||||
* denotes uncertainty