Magnesium sulphate for acute bronchiolitis in children up to two years of age

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Plain language summary

Review question

We investigated the effectiveness and safety of magnesium sulphate for treating children up to two years old with acute bronchiolitis.

Background

Acute bronchiolitis is caused by a virus, and mostly affects children up to two years old. This condition blocks small airways in the lungs, causing coughing, wheezing, and breathing difficulties. Usual treatment involves supportive care, which includes providing adequate fluids and humidified oxygen. Children with bronchiolitis may need intensive care treatment.

Search date

Evidence is current to 30 April 2020.

Study characteristics

We included four studies (564 children) conducted in Qatar, Turkey, Iran, and India. Three studies included children with moderate to severe bronchiolitis. Studies compared magnesium sulphate, given via a tube into a vein (intravenous), or as a fine inhaled spray (nebulised), with a dummy treatment (known as a placebo – something that looks like magnesium sulphate treatment), medicines to open the airways (salbutamol or epinephrine), a salt water solution (hypertonic saline), or no treatment.

Study funding sources

One study received funding from a hospital and one from a university; two studies did not report funding sources.

Key results

There was not enough evidence to know if intravenous or nebulised magnesium sulphate, either alone or combined with other treatments, improved bronchiolitis outcomes in children up to two years old. We could not determine if magnesium sulphate reduced deaths, unexpected medical problems during treatment, time spent in hospital, or illness severity (based on doctors' clinical assessment scores). Time taken to recovery was not measured.

Certainty of the evidence

Overall, we are very uncertain of the results.