Comparative efficacy and safety of magnesium Sulfate in Pediatric versus adult acute asthma exacerbations: An overview of systematic reviews and Meta analyses.

OBJECTIVE

To conduct an overview of existing systematic reviews and meta-analyses on magnesium sulfate for acute asthma in children and adults, and to develop evidence-based, age-specific nursing interventions.

METHODS

We searched PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP, WANFANG, and CBM from inception to August 10, 2025, for systematic reviews and meta-analyses on magnesium sulfate for acute asthma in children and adults. Primary study overlap was assessed using citation matrices and the corrected covered area. Quality was evaluated with ROBIS, AMSTAR-2, PRISMA 2020, and GRADE tools. Primary outcomes were then analyzed quantitatively and qualitatively to interpret the evidence.

RESULTS

Eighteen systematic reviews/meta-analyses were included. Primary study overlap was mild (corrected covered area = 5.090%). ROBIS indicated low risk of bias for all studies. AMSTAR-2 ratings: 4 high, 1 moderate, 12 low, 1 critically low. PRISMA 2020 scores (22-41) corresponded to 5 high, 12 moderate, and 1 low reporting quality. GRADE outcomes were high (n = 4), moderate (n = 31), low (n = 30), or extremely low (n = 27) quality.

CONCLUSION

Magnesium sulfate demonstrates a clearer benefit in children, reducing hospitalizations and improving physiological outcomes. In adults, it primarily lowers hospitalization risk without consistently improving lung function. Safety appears acceptable in both groups.

IMPLICATIONS TO PRACTICE: For pediatric acute asthma, magnesium sulfate may be used as second- or third-line adjunctive therapy. For critically ill adults, it should be an individualized option, not routine. Guidelines and nursing protocols should incorporate these age-stratified recommendations.