TOPLINE:

Intravenous (IV) administration of magnesium sulphate was associated with a reduced risk for in-hospital mortality and 30-day all-cause ICU mortality but possibly extended ICU and hospital stays among patients with acute respiratory distress syndrome (ARDS).

METHODOLOGY:

• Researchers conducted a retrospective study and analyzed data of patients with ARDS from the Medical Information Mart for Intensive Care IV database, treated between 2008 and 2019, to assess the correlation between the use of magnesium sulphate and mortality.
• They included 4858 patients who received IV magnesium sulphate during their ICU stay and propensity-matched them into two groups of 641 patients each: a treatment group (mean age, 58.69 years; 39.16% women) and a control group (mean age, 57.82 years; 36.82% women).
• The primary outcome was in-hospital mortality, whereas secondary outcomes included 30-day all-cause mortality and lengths of ICU and hospital stay.

TAKEAWAY:

• Administration of magnesium sulphate was associated with a 29% lower risk for in-hospital mortality (hazard ratio [HR], 0.71; P < .001) and a 25% lower risk for 30-day all-cause ICU mortality (HR, 0.75; P = .002).
• The treatment vs control group had significantly longer ICU stays (median length of stay, 3.89 vs 2.85 days; regression coefficient [β], 2.05; P < .001) and hospital stays (median length of stay, 8.09 vs 6.92 days; β, 2.21; P =.001).

IN PRACTICE:

“[Our] finding suggests that more attention should be paid to changes in serum magnesium levels in critically ill patients, particularly those diagnosed with hypomagnesaemia,” the authors wrote. “A wider range of patients in the ICU can also benefit from magnesium sulphate therapy, including, but not limited to, patients with sepsis and COPD [chronic obstructive pulmonary disease],” they added.

SOURCE:

The study was led by Yuan-Feng Cao, Hunan Aerospace Hospital, Changsha, China. It was published online on October 10, 2025, in Scientific Reports.

LIMITATIONS:

This study was limited by its retrospective design, which may have made the results prone to residual bias and unmeasured confounding. The study lacked dynamic analyses of plasma magnesium sulphate concentrations and clear guidelines for initiating or discontinuing treatment. Additionally, advances in the treatment of ARDS during the study period may have affected the results.

DISCLOSURES:

This study was supported by the National Natural Science Foundation of China and the Chengdu Medical Research Project. The authors reported having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.