Magnesium Sulfate and Helium–Oxygen for Severe Acute Asthma

Abstract

Magnesium sulphate and helium oxygen are adjuvant therapy of potential interest in acute severe asthma. The purpose of this review is to identify their indications in acute severe asthma. Magnesium sulfate plays a role in smooth muscle relaxation, and has anti-inflammatory properties, thereby contributing to relief of airflow obstruction. Intravenous Magnesium sulphate weakly improves spirometric parameters during acute severe asthma, and may decrease subsequent hospitalization rate in both adults and children. Inhaled magnesium sulphate has no identified effect in adults, but may improve spirometric parameters in children with a short duration of severe asthma symptoms associated with hypoxia.

In acute severe asthma, helium-oxygen mixture may be used as a propellant gas to improve bronchodilator nebulization, or as an inhaled gas to take advantage of its physicochemical properties which have the potential to improve airway resistance and work of breathing. Helium-oxygen-driven β2-agonist nebulization improves spirometric parameters in acute asthma, provided specific administration modalities are applied. On the other hand, helium-oxygen mixture used as an inhaled gas should not be recommended in the treatment of severe acute asthma, due to the lack of evidence at this time.