EFFICACY OF MAGNESIUM CITRATE CATHARTIC IN PEDIATRIC TOXIC INGESTIONS

Study objective: To investigate the efficacy of magnesium citrate in r educing gastrointestinal transit time of activated charcoal in childre n. Design: A prospective, randomized, clinical comparison of four magn esium doses. Setting: Urban children's hospital emergency department. Participants: Children aged 1 month to 6 years who presented for manag ement of an acute toxic ingestion. Intervention: Each child received 1 g/kg activated charcoal combined with a randomly assigned dose of a 6 % solution of magnesium citrate: 0 mL/kg, 4 mL/kg (standard recommende d dose), 6 mL/kg, or 8 mL/kg. The primary outcome measure was the inte rval to first activated charcoal-containing stool, which was determine d by follow-up telephone call or review of the medical record. Results : Sixty-four children were enrolled. Median times to first charcoal st ool were 19.5 hours (0 mL/kg), 13.0 hours (4 mL/kg), 14.0 hours (6 mL/ kg), and 12.0 hours (8 mL/kg). Intergroup differences were significant by Kruskal-Wallis analysis of variance (P = .0035). Conclusion: Magne sium citrate reduces gastrointestinal transit times of activated charc oal stools when administered to children who receive activated charcoa l for a toxic ingestion. Further study is needed to determine the clin ical value of this reduction.