Summary of findings 1. Magnesium sulphate compared with placebo for acute bronchiolitis in children.
| Magnesium sulphate versus placebo for acute bronchiolitis in children | ||||||
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Patient or population: children up to 18 months old with acute bronchiolitis Settings: short stay unit, paediatric emergency department Intervention: magnesium sulphate Comparison: placebo | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Placebo | Magnesium sulphate | |||||
| Time to recovery | ‐ | ‐ | ‐ | ‐ | ‐ | Outcome not measured |
| Mortality | See comment | See comment | Not estimable | 160 (1 RCT) | See comment | Trial authors confirmed there were no deaths in either group (personal communication) |
| Adverse events | See comment | See comment | Not estimable | 160 (1 RCT) | See comment | Neither group reported adverse effects, such as apnoea, cyanosis, or haemodynamic instability |
| Duration of hospital stay | Geometric mean time to discharge was 25.3 hours in the placebo group. | Geometric mean time to discharge was 24.1 hours in the magnesium sulphate group. | Not estimable | 160 (1 RCT) | See comment | Results were taken directly from the published report. |
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Clinical severity score (CSS) (Wang score; range 0 to 12; higher = poorer outcome) measured at 0 to 24 hours after treatment |
The mean (SD) CSS at 24 hours in the placebo group was 4.55 points (1.62) | The mean CSS at 24 hours in the magnesium sulphate group was 0.13 points higher (0.28 lower to 0.54 higher) | MD 0.13, (‐0.28 to 0.54) | 160 (1 RCT) | ⊕⊝⊝⊝ very lowa |
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Clinical severity score (CSS) (Wang score; range 0 to 12; higher = poorer outcome) measured at 25 to 48 hours after treatment |
The mean (SD) CSS at 48 hours in the placebo group was 4.84 points (1.57) | The mean CSS at 48 hours in the magnesium sulphate group was 0.42 points lower (0.84 lower to 0) | MD ‐0.42, (‐0.84 to ‐0.00) |
160 (1 RCT) | ⊕⊝⊝⊝ very lowa |
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Hospital re‐admission within 30 days of discharge (re‐admissions were reported at 14 days) |
62 per 1000 | 195 per 1000 | RR 3.16 (1.20 to 8.27) | 158 (1 RCT) | ⊕⊕⊝⊝ lowb | |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio; MD: mean difference; SD: standard deviation; RCT: randomised controlled trial | ||||||
| GRADE Working Group grades of evidence High quality. Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality. Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality. Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality. We are very uncertain about the estimate. | ||||||
aWe downgraded the quality of the evidence to very low for indirectness and very serious imprecision (1 study, small sample size, wide confidence intervals). bWe downgraded the quality of the evidence to low for indirectness and serious imprecision (1 study, small sample size).