A multicenter randomized controlled trial of intravenous magnesium for sickle cell pain crisis in children

for the Pediatric Emergency Care Applied Research Network (PECARN)

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)1651-1657
Number of pages7
JournalBlood
Volume126
Issue number14
DOIs
StatePublished - Oct 1 2015

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ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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