TY - JOUR
T1 - A multicenter randomized controlled trial of intravenous magnesium for sickle cell pain crisis in children
AU - for the Pediatric Emergency Care Applied Research Network (PECARN)
AU - Brousseau, David C.
AU - Scott, J. Paul
AU - Badaki-Makun, Oluwakemi
AU - Darbari, Deepika S.
AU - Chumpitazi, Corrie E.
AU - Airewele, Gladstone E.
AU - Ellison, Angela M.
AU - Smith-Whitley, Kim
AU - Mahajan, Prashant
AU - Sarnaik, Sharada A.
AU - Casper, T. Charles
AU - Cook, Lawrence J.
AU - Dean, J. Michael
AU - Leonard, Julie
AU - Hulbert, Monica L.
AU - Powell, Elizabeth C.
AU - Liem, Robert I.
AU - Hickey, Robert
AU - Krishnamurti, Lakshmanan
AU - Hillery, Cheryl A.
AU - Nimmer, Mark
AU - Panepinto, Julie A.
N1 - Publisher Copyright:
© 2015 by The American Society of Hematology.
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Magnesium, a vasodilator, anti-inflammatory, and pain reliever, could alter the pathophysiology of sickle cell pain crises.Wehypothesized that intravenousmagnesiumwould shorten length of stay, decrease opioid use, and improve health-related quality of life (HRQL) for pediatric patients hospitalized with sickle cell pain crises. The Magnesium for Children in Crisis (MAGiC) study was a randomized, double-blind, placebo-controlled trial of intravenous magnesium vs normal saline placebo conducted at 8 sites within the Pediatric Emergency Care Applied Research Network (PECARN). Children 4 to 21 years old with hemoglobin SS or Sb0 thalassemia requiring hospitalization for pain were eligible. Children received 40 mg/kg of magnesium or placebo every 8 hours for up to 6 doses plus standard therapy. The primary outcomewaslengthof stay inhours fromthetimeof firststudydruginfusion,comparedusing a Van Elteren test. Secondary outcomes included opioid use and HRQL. Of 208 children enrolled, 204 received the study drug (101 magnesium, 103 placebo). Between-group demographics and prerandomization treatment were similar. The median interquartile range (IQR) length of stay was 56.0 (27.0-109.0) hours formagnesiumvs 47.0 (24.0-99.0) hours for placebo (P =.24). Magnesium patients received 1.46 mg/kg morphine equivalents vs 1.28 mg/kg for placebo (P =.12). Changes in HRQL before discharge and 1 week after discharge were similar (P >.05 for all comparisons). The addition of intravenous magnesium did not shorten length of stay, reduce opioid use, or improve quality of life in children hospitalized for sickle cell pain crisis.
AB - Magnesium, a vasodilator, anti-inflammatory, and pain reliever, could alter the pathophysiology of sickle cell pain crises.Wehypothesized that intravenousmagnesiumwould shorten length of stay, decrease opioid use, and improve health-related quality of life (HRQL) for pediatric patients hospitalized with sickle cell pain crises. The Magnesium for Children in Crisis (MAGiC) study was a randomized, double-blind, placebo-controlled trial of intravenous magnesium vs normal saline placebo conducted at 8 sites within the Pediatric Emergency Care Applied Research Network (PECARN). Children 4 to 21 years old with hemoglobin SS or Sb0 thalassemia requiring hospitalization for pain were eligible. Children received 40 mg/kg of magnesium or placebo every 8 hours for up to 6 doses plus standard therapy. The primary outcomewaslengthof stay inhours fromthetimeof firststudydruginfusion,comparedusing a Van Elteren test. Secondary outcomes included opioid use and HRQL. Of 208 children enrolled, 204 received the study drug (101 magnesium, 103 placebo). Between-group demographics and prerandomization treatment were similar. The median interquartile range (IQR) length of stay was 56.0 (27.0-109.0) hours formagnesiumvs 47.0 (24.0-99.0) hours for placebo (P =.24). Magnesium patients received 1.46 mg/kg morphine equivalents vs 1.28 mg/kg for placebo (P =.12). Changes in HRQL before discharge and 1 week after discharge were similar (P >.05 for all comparisons). The addition of intravenous magnesium did not shorten length of stay, reduce opioid use, or improve quality of life in children hospitalized for sickle cell pain crisis.
UR - https://www.scopus.com/pages/publications/84947996077
U2 - 10.1182/blood-2015-05-647107
DO - 10.1182/blood-2015-05-647107
M3 - Article
C2 - 26232172
AN - SCOPUS:84947996077
SN - 0006-4971
VL - 126
SP - 1651
EP - 1657
JO - Blood
JF - Blood
IS - 14
ER -