Published: 2021-05-25

Magnesium sulphate nebulization in acute bronchiolitis in infants: a randomized controlled trial

Shivhar K. Janakwade, Sadbhavana Pandit, Neeraj Dhawan



Background: Acute bronchiolitis is a disorder of the lower respiratory tract that occurs mostly in between 1 month to 24 months. There are limited numbers of studies on magnesium sulphate nebulization in acute bronchiolitis. There is a desperate need for a standard treatment which can reduce the morbidity and mortality in acute bronchiolitis. The goal was to study the efficacy of magnesium sulphate nebulization in infants with acute bronchiolitis.

Methods: It was a prospective open labelled randomized controlled study. Children in age group of 2-12 months admitted with clinical diagnosis of acute bronchiolitis in paediatric emergency ward, GMSH-16, Chandigarh. Study group patients were treated with 40 mg/kg magnesium sulphate nebulization diluted with 2-3 ml normal saline in addition to supportive treatment as oxygen and IV fluids, three doses of medication were given at 1 hour interval and it was not repeated after three doses. Control group patients were treated with oxygen therapy, IV fluids, symptomatic treatment for fever and supportive care.

Results: Respiratory distress assessment instrument score and length of hospital stay was significantly lesser in study group as compared to control group. SpO2 was significantly more in study group as compared to control group.

Conclusions: Magnesium sulphate nebulization is effective in improving respiratory distress and oxygen saturation, it also reduces duration of hospital stay in infants with mild to moderate bronchiolitis.


Magnesium sulphate, Nebulization, Bronchiolitis

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Gupta S, Shamsundar R, Shet A, Chawan R, Srinivasa H. Prevalance of respiratory syncytial virus infection among hospitalised children presenting with acute lower respiratory tract infection. Indian J Pediatr. 2011;78(12):1495-7.

Dennis MM. Bonchiolitis. Arch Dis Child Educ Pract. 2005;90:81-6.

Bria MC, Lauren EC, Denise MG. Wheezing in infants, bronchiolitis. In: Kliegman RM, Stanton BF, Geme JW, Schor MF, eds. Nelson Textbook of Pediatrics, 20th ed. Philadelphia: Elsevier; 2016:2044-8.

Zorc JJ, Hall CB. Bronchiolitis: recent evidence on diagnosis and management. Pediatrics. 2010;125(2):342-9.

American Academy of Pediatrics Subcommittee on Diagnosis and management of Bronchiolitis. Pediatrics. 2006;118(4):1174-93.

Gaddomski AM, Scribani MB. Bronchodilators for bronchiolitis. Cochrane Database Syst Rev. 2014;(6):001266.

Harting L, Bialy LM, Vandermeer B, Tjosvold L, Johnson DW, Plint AC, et al. Epinephrine for bronchiolitis. Cochrane Database Syst Rev. 2011;6:003123.

Patel H, Platt R, Lozano JM, Wang EE. Glucocorticoids for acute viral bronchiolitis in infants and young children. Cochrane Database Syst Rev. 2008;1:004878.

Perrotta C, Ortiz Z, Roque M. Chest physiotherapy for acute bronchiolitis in pediatric patients between 0 and 24 months old. Cochrane Database Syst Rev. 2005;2:4873.

Landrigan CP, Conway PH, Stucky ER, Chiang VW, Ottolini MC. Variation in pediatric hospitalists use of proven and unproven therapies: a study from the Pediatric Research in Inpatients setting (PRIS) network. J Hosp Med. 2008;3(4):292-8.

Modaresi MR, Faghihinia J, Kelishadi R, Reisi M, Mirlohi S, Pajhang F, et al. Nebulized magnesium sulfate in acute bronchiolitis: a randomized controlled trial. Indian J Pediatr. 2015;82(9):794-8.

Kose M, Mehmet AO, Hakan P, Tuba E, Duygu E, Filiz T, et al. The efficacy of nebulized salbutamol, magnesium sulphate and salbutamol/magnesium sulfate combination in moderate bronchiolitis. Eur J Pediatr. 2014;173(9):1157-60.

Ralston SL, Allen SL, Meissner HC, Alverson BK, Baley JE, Godomski AM, et al. Clinical practice guideline: the diagnosis, management and prevention of bronchiolitis. Am Aca Paediat. 2014:134(5):1474-502.

Lowell DI, Lister G, Von Koss H, McCarthy P. Wheezing in infants: the response to epinephrine, Pediatrics. 1987;79(6):939-45.

National Institute for Health and Care Excellence (NICE) guidance. Fact sheet: Bronchiolitis in children. 2015. Available at: Accessed on 2 March 2021.

Powell C, Kolamunnage-Dona R, Lowe J, Boland A, Petrou S, Doull I, et al. Magnesium sulphate in acute severe asthma in children (MAGNETIC) : a randomised, placebo-controlled trial. The Lancet Resp Med. 2013;1(4):301-8.