We thank W.F.S. Sellers and M.F.M. James for their correspondence in response to our review on the use of intravenous magnesium sulphate in acute asthma in childhood [1] and welcome their comments. Salbutamol induced tachycardia and palpitations are a concern in younger children when treated with large doses of salbutamol [2]. Emphasising the effect that magnesium has on reducing this tachycardia is important. We were aware of the lack of evidence for the 20-min infusion rate but did not mention it in the paper. Recognising that it is safe and may have a greater effect if delivered at a greater speed will be useful for further development of randomised controlled acute asthma in childhood studies. This illustrates how important it is to share experience across specialties.
Short abstract
Intravenous magnesium sulphate reduces β2-agonist induced tachycardia https://bit.ly/3pPnGKl
Reply to: W.F.S. Sellers and M.F.M. James:
We thank W.F.S. Sellers and M.F.M. James for their correspondence in response to our review on the use of intravenous magnesium sulphate in acute asthma in childhood [1] and welcome their comments. Salbutamol induced tachycardia and palpitations are a concern in younger children when treated with large doses of salbutamol [2]. Emphasising the effect that magnesium has on reducing this tachycardia is important. We were aware of the lack of evidence for the 20-min infusion rate but did not mention it in the paper. Recognising that it is safe and may have a greater effect if delivered at a greater speed will be useful for further development of randomised controlled acute asthma in childhood studies. This illustrates how important it is to share experience across specialties.
Footnotes
Conflict of interest: The authors have nothing to disclose.
References
- 1.Erumbala G, Anzar S, Tonbari A, et al. Stating the obvious: intravenous magnesium sulphate should be the first parenteral bronchodilator in paediatric asthma exacerbations unresponsive to first-line therapy. Breathe 2021; 17: 210113. doi: 10.1183/20734735.0113-2021 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Starkey ES, Mulla H, Sammons HM, et al. Intravenous salbutamol for childhood asthma: evidence-based medicine? Arch Dis Child 2014; 99: 873–877. doi: 10.1136/archdischild-2013-304467 [DOI] [PubMed] [Google Scholar]