Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Wheezy chest remains one of the major causes for emergency department visits and admissions at pediatric intensive care units (PICUs). We aimed to determine the efficacy of magnesium sulfate (MgSo4) versus standard treatment in critically ill infants and children with wheezy chest. A randomized controlled trial comprised 81 patients suffering from wheezy chest divided into 3 groups. In addition to bronchodilators and systemic steroids, MgSo4 was given by inhalation in group A, intravenously in group B, and group C didn't receive MgSo4. The improvement in our cases was determined by clinical respiratory score (CRS), ventilator setting and arterial blood gases before and after treatment. Median age was 11 months, mean weight 9.3kg and the median of SOFA score was one. After treatment: There was significant improvement of CRS, respiratory rate and air entry in the three groups. Significant improvement in intercostals and subcostal retraction, mental state in group A and B; (p=0.03/0.002, p=0.0003/0.032; respectively). In group A, there was significant reduction in ventilator rate (p=0.017) and improvement of arterial/inspired oxygen ratio (p=0.0056). In group B, significant improvement in the color of the patients (p=0.0005) and a better mean arterial pH was noted (p=0.009). No significant rise in serum magnesium level. The median duration of oxygen supply and PICU stay was higher in group C compared to A and B. Magnesium sulfate is a safe and beneficial adjuvant therapy in addition to standard treatment in critically ill infants and children with wheezy chest

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