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Efectos del sulfato de magnesio en lactantes con Bronquiolitis aguda: revisión sistemática y metaanálisis.

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Title: Efectos del sulfato de magnesio en lactantes con Bronquiolitis aguda: revisión sistemática y metaanálisis.
Alternate Title: Effects of magnesium sulfate in infants with acute bronchiolitis: systematic review and meta-analysis.
Authors: Luarte-Martínez, Soledad1, Giacomozzi Medel, Pablo2,3,4, Vera Mendoza, Valentina1, Rodríguez-Núñez, Iván1, Dubo, Sebastian1 sedubo@udec.cl
Source: Andes Pediatrica. may/jun2026, Vol. 97 Issue 3, p534-543. 10p.
Subjects: Magnesium sulfate, Bronchiolitis, Evidence synthesis, Clinical trials, Hospital care, Infants, Drug therapy, Statistics
Abstract (English): Acute bronchiolitis is the leading cause of hospitalization in infants, with few pharmacological treatments of proven efficacy. Given that magnesium sulfate (MgSO4) has shown benefits in the management of asthma, it has been proposed as a potential adjuvant therapy; however, the evidence remains limited. Objective: To evaluate the effectiveness of MgSO4, compared with standard therapy with or without placebo, in reducing symptoms and length of hospital stay in infants with bronchiolitis. Methods: A systematic review of randomized clinical trials (RCTs) was conducted. Searches were performed using MEDLINE, EMBASE, SciELO, LILACS, clinical trial registries, grey literature, and bibliographic reviews (last search: December 2, 2025). Studies including infants under 24 months with acute bronchiolitis were selected. Risk of bias was assessed using the RoB2 tool. A meta-analysis was performed using a random-effects model. The primary outcome was clinical response (at 1 hour and 3-4 hours), and the secondary outcome was length of hospital stay. Results were synthesized using standardized mean differences (SMD) and mean differences (MD). Results: Four RCTs were included (n = 401). MgSO4 showed no significant differences compared with standard therapy in clinical improvement at 1 hour (SMD: 0.17 95%CI -0.23 to 0.57) or at 3-4 hours (SMD: -0.07 95%CI -0.32 to 0.19). Length of hospital stay also showed no significant differences (MD: -0.34 hours 95%CI -3.39 to 2.72). The certainty of the evidence was rated as low to moderate according to GRADE. Conclusions: Magnesium sulfate does not provide clinically significant benefits in reducing symptoms or length of hospital stay in acute bronchiolitis. According to the GRADE approach, there is a conditional recommendation against its routine use in infants with acute bronchiolitis, based on low to moderate certainty evidence. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): La bronquiolitis aguda es la principal causa de hospitalización en lactantes, existiendo escasos tratamientos farmacológicos con eficacia demostrada. Dado que el sulfato de magnesio (MgSO4) ha mostrado beneficios en el manejo del asma, se ha propuesto como posible terapia adyuvante, sin embargo, la evidencia sigue siendo limitada. Objetivo: Evaluar la efectividad del MgSO4, comparada con terapia estándar con o sin placebo, para reducir síntomas y tiempo de hospitalización en lactantes con bronquiolitis. Metodología: Revisión sistemática de ensayos clínicos aleatorizados (ECA). Se realizaron búsquedas en MEDLINE, EMBASE, SciELO, LILACS, registros de ensayos clínicos, literatura gris y revisión de bibliografías (última búsqueda: 2 diciembre 2025). Se incluyeron estudios que consideraron lactantes menores de 24 meses con bronquiolitis aguda. Se evaluó riesgo de sesgo con ROB2. Se realizó metaanálisis con modelo de efectos aleatorios. La variable resultado primaria fue la respuesta clínica (a 1 hora y 3-4 horas) y la secundaria, fue el tiempo de estadía hospitalaria. Los resultados se sintetizaron usando diferencias de medias estandarizadas (SMD) y diferencias de medias (DM). Resultados: Se incluyeron cuatro ECA (n=401). El MgSO4 no mostró diferencias significativas frente a terapia estándar en la mejoría clínica a 1 hora (SMD: 0,17 IC95 % -0,23 a 0,57) ni a 3–4 horas (SMD: -0,07 IC95 % -0,32 a 0,19). El tiempo de hospitalización tampoco presentó diferencias relevantes (DM: -0,34 horas IC95 % -3,39 a 2,72). La certeza de la evidencia fue calificada como baja a moderada según GRADE. Conclusiones: El Sulfato de Magnesio no ofrece beneficios clínicamente significativos en reducción de síntomas, ni en tiempo de hospitalización en bronquiolitis aguda. De acuerdo con el enfoque GRADE, existe una recomendación débil en contra de su uso rutinario en lactantes con bronquiolitis aguda, basada en evidencia de baja a moderada certeza. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
Description
Abstract:Acute bronchiolitis is the leading cause of hospitalization in infants, with few pharmacological treatments of proven efficacy. Given that magnesium sulfate (MgSO4) has shown benefits in the management of asthma, it has been proposed as a potential adjuvant therapy; however, the evidence remains limited. Objective: To evaluate the effectiveness of MgSO4, compared with standard therapy with or without placebo, in reducing symptoms and length of hospital stay in infants with bronchiolitis. Methods: A systematic review of randomized clinical trials (RCTs) was conducted. Searches were performed using MEDLINE, EMBASE, SciELO, LILACS, clinical trial registries, grey literature, and bibliographic reviews (last search: December 2, 2025). Studies including infants under 24 months with acute bronchiolitis were selected. Risk of bias was assessed using the RoB2 tool. A meta-analysis was performed using a random-effects model. The primary outcome was clinical response (at 1 hour and 3-4 hours), and the secondary outcome was length of hospital stay. Results were synthesized using standardized mean differences (SMD) and mean differences (MD). Results: Four RCTs were included (n = 401). MgSO4 showed no significant differences compared with standard therapy in clinical improvement at 1 hour (SMD: 0.17 95%CI -0.23 to 0.57) or at 3-4 hours (SMD: -0.07 95%CI -0.32 to 0.19). Length of hospital stay also showed no significant differences (MD: -0.34 hours 95%CI -3.39 to 2.72). The certainty of the evidence was rated as low to moderate according to GRADE. Conclusions: Magnesium sulfate does not provide clinically significant benefits in reducing symptoms or length of hospital stay in acute bronchiolitis. According to the GRADE approach, there is a conditional recommendation against its routine use in infants with acute bronchiolitis, based on low to moderate certainty evidence. [ABSTRACT FROM AUTHOR]
ISSN:24526045
DOI:10.32641/andespediatr.v97i3.5915