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Introduction: Magnesium sulphate (MgSO4) therapy has shown to be useful as a neurological protector in the preterm newborn below 32 weeks of gestation. The most documented adverse effect is cardiorespiratory failure, whereas its relationship with meconium obstruction is controversial. The main objective of this study was to analyse the possible association between prenatal MgSO4 therapy and meconium obstruction. Patients and methods: An analytical retrospective study was conducted on

OBJETIVOS: estudar os efeitos da administração endovenosa de sulfato de magnésio (MgEV) ou de salbutamol (SalbEV) em crianças com crise de asma aguda. MÉTODOS: estudo randomizado, duplo-cego e controlado por placebo. Incluídas crianças maiores de 2 anos admitidas em sala de observação com crise de asma aguda grave (refratária a três nebulizações com beta-adrenérgicos). Após a admissão, recebiam tratamento convencional (oxigênio, corticóides, nebulizações com beta-adrenérgicos) e eram alocadas a receber uma de três soluções indistinguíveis entre si: a) MgEV (50 mg/kg); b) SalbEV (20 µg/kg); ou c) solução salina, que eram administradas em 20 minutos (1ml/kg/hora). Avaliações clínicas, dosagens de eletrólitos e gases arteriais foram registrados antes e 1 hora após a infusão das drogas. RESULTADOS: foram estudados 50 pacientes (+ 4,5 anos e 53% de meninas), sem diferenças significativas entre os 3 grupos. No grupo MgEV, observou-se redução da pressão arterial durante a infusão, que retornou ao normal 1 hora após, associado com aumento (p < 0,001) do magnésio e pH sérico e diminuição no PaCO2. No grupo SalbEV, durante a administração, observou-se diminuição da freqüência respiratória (p = 0,05) e aumento da pressão arterial, (p = 0,01). Após 1 hora, houve diminuição da freqüência respiratória (p = 0,02); queda no potássio sérico (p = 0,009), no PaCO2 e elevação no pH. Comparado com os grupos MgEV e placebo, o grupo SalbEV necessitou menos nebulizações (p = 0,009), menor número de nebulizações por paciente por dia (p < 0,001) e menor tempo de uso de oxigênio. No grupo placebo, a acidose foi mais persistente (p < 0,01). Não houve diferença no tempo de permanência hospitalar dos 3 grupos. A ventilação mecânica foi necessária em 10% dos casos. CONCLUSÕES: demonstrou-se que a administração endovenosa precoce de sulfato de magnésio e, principalmente, o salbutamol em associação ao tratamento convencional para asma aguda em crianças são terapêuticas efetivas e que podem potencializar o efeito broncodilatador.OBJECTIVE: To study the efficacy of intravenous magnesium sulfate and intravenous salbutamol in the treatment of severe asthma in children. METHODS: Randomized, double-blind, placebo-controlled clinical trial, including children above 2 years of age with severe acute asthma admitted to the observation ward of the Pediatric Intensive Care Unit of Hospital São Lucas. All patients received conventional treatment (oxygen, corticoids, beta-adrenergics) on admission, and later received one of the following solutions: a) IVMg (50 mg/kg); b) intravenous salbutamol (20 µg/kg); c) saline solution (1 ml/kg/min). Clinical assessments, electrolyte concentration, and arterial blood gas analyses were recorded before intravenous infusion and one hour after that. RESULTS: Fifty patients participated in this study (of whom 53% were females, mean age = 4.5 years). There were no significant differences among the three groups. The group that received IVMg presented lower blood pressure during administration, which reached normal levels one hour afterwards, along with an increase in serum magnesium (P < 0,001) and serum pH, and reduction of PaCO2. The group that received intravenous salbutamol had lower respiratory rate (P = 0.05) and higher blood pressure (P = 0.01), and one hour after administration, these patients showed decreased respiratory rate (P = 0.02); lower levels of serum potassium (P = 0.009); higher pH, and reduced PaCO2. This group required fewer nebulizations (P = 0.009), fewer nebulizations per day (P

Introduction: The published evidence on the association between magnesium sulphate (MgSO 4 ) and delayed passage of meconium (DPM) is contradictory., Objectives: To determine whether there is an association between the administration of MgSO 4 to the mother and DPM in the neonate, and to analyse serum magnesium levels in neonates in relation to the cumulative dose of MgSO 4 administered to the mother., Population and Methods: Retrospective and prospective descriptive and analytical study conducted in patients delivered at or before 32 weeks of gestation in 2 tertiary care hospitals. Delayed passage of meconium was defined as failure to pass meconium within 48 h of birth and/or need for rectal stimulation on 2 or more occasions to pass stool and/or interval of at least 48 h between the first and second bowel movements., Results: The study included 283 patients (204 retrospectively and 79 prospectively), of who 152 (53.7%) experienced DPM. Delayed passage of meconium was not associated with antenatal MgSO 4 administration, the cumulative maternal MgSO4 dose or neonatal serum magnesium levels. Older gestational age (OR, 0.8; confidence interval [CI], 0.69-0.93; P = 0.003) was an independent protective factor against DPM, while the need for advanced resuscitation (OR, 2.24; CI 1.04-4.86; P = 0.04) was a risk factor for DPM., Conclusion: The neonatal serum levels of magnesium reached with the doses of MgSO 4 administered to mothers were not associated with DPM. Lower gestational age and the need for advanced resuscitation were predictors associated with an increased risk of DPM., (Copyright © 2022 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Magnesium sulphate (MgSO 4 ) therapy has shown to be useful as a neurological protector in the preterm newborn below 32 weeks of gestation. The most documented adverse effect is cardiorespiratory failure, whereas its relationship with meconium obstruction is controversial. The main objective of this study was to analyse the possible association between prenatal MgSO 4 therapy and meconium obstruction., Patients and Methods: An analytical retrospective study was conducted on <32 weeks preterm babies admitted to a tertiary-level hospital (January 2016-December 2017). Epidemiological, prenatal and postnatal data on the outcomes were obtained, analysed and compared in both groups (exposed to MgSO 4 and not exposed)., Results: The study included 201 patients (146 exposed and 55 non-exposed). There were no significant differences in the mean gestational age (28.4 ± 2.2 vs. 28.7 ± 2.8 weeks, respectively), or in the rest of epidemiological and perinatal variables. Prenatal corticosteroid therapy was more frequent in the MgSO 4 group (75.9 vs. 53.7%; p = .002), and in the non-exposed group there were more multiple pregnancies (52.7 vs. 36.6%; p = .027), and female gender (56.4 vs. 37%; p = .013). There were no statistically significant differences in the presence of meconium obstruction (75.9% in exposed vs. 67.3% in non-exposed; p = .23), although repeated rectal stimulation was more frequent in the exposed group (43.2 vs. 27.9%; p = .08). Furthermore, there were no significant differences in the main cardiorespiratory variables: 1-min Apgar score (6.2 in MgSO 4- exposed vs. 5.6 in non-exposed; p = .75), 5-min Apgar score (7.9 vs. 7.6; p = .31), advanced newborn resuscitation (26 vs. 31.5%; p = .44), maximum FiO 2 (45.5 vs. 48; p = .58), and initial inotropic requirements (10.3 vs. 20.8%; p = .55)., Conclusions: This study found no correlations between MgSO 4 therapy and meconium obstruction or cardiorespiratory failure., (Copyright © 2022. Published by Elsevier España, S.L.U.)

Introduction: Magnesium sulphate (MgSO 4 ) therapy has shown to be useful as a neurological protector in the preterm newborn below 32 weeks of gestation. The most documented adverse effect is cardiorespiratory failure, whereas its relationship with meconium obstruction is controversial. The main objective of this study was to analyse the possible association between prenatal MgSO 4 therapy and meconium obstruction., Patients and Methods: An analytical retrospective study was conducted on < 32 weeks preterm babies admitted to a tertiary-level hospital (January 2016-December 2017). Epidemiological, prenatal and postnatal data on the outcomes were obtained, analysed and compared in both groups (exposed to MgSO 4 and not exposed)., Results: The study included 201 patients (146 exposed and 55 non-exposed). There were no significant differences in the mean gestational age (28.4 ± 2.2 vs. 28.7 ± 2.8 weeks, respectively), or in the rest of epidemiological and perinatal variables. Prenatal corticosteroid therapy was more frequent in the MgSO 4 group (75.9 vs. 53.7%; p = .002), and in the non-exposed group there were more multiple pregnancies (52.7 vs. 36.6%; p = .027), and female gender (56.4 vs. 37%; p = .013). There were no statistically significant differences in the presence of meconium obstruction (75.9% in exposed vs. 67.3% in non-exposed; p = .23), although repeated rectal stimulation was more frequent in the exposed group (43.2 vs. 27.9%; p = .08). Furthermore, there were no significant differences in the main cardiorespiratory variables: 1-minute Apgar score (6.2 in MgSO 4 - exposed vs. 5.6 in non-exposed; p = .75), 5-minutes Apgar score (7.9 vs. 7.6; p = .31), advanced newborn resuscitation (26 vs. 31.5%; p = .44), maximum FiO 2 (45.5 vs. 48; p = .58), and initial inotropic requirements (10.3 vs. 20.8%; p = .55)., Conclusions: This study found no correlations between MgSO4 therapy and meconium obstruction or cardiorespiratory failure., (Copyright © 2020. Publicado por Elsevier España, S.L.U.)