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Magnesium and coronary revascularization.

M N Harris1, A Crowther, R A Jupp

  • 1Department of Anaesthetics, St Thomas' Hospital, London.

British Journal of Anaesthesia
|June 1, 1988
PubMed
Summary
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Administering magnesium chloride during cardiopulmonary bypass significantly reduced arrhythmias in patients undergoing coronary revascularization. This intervention prevented hypomagnesaemia, improving patient outcomes without affecting QT intervals.

Area of Science:

  • Cardiovascular Surgery
  • Clinical Pharmacology
  • Cardiac Electrophysiology

Background:

  • Coronary revascularization procedures often involve cardiopulmonary bypass.
  • Maintaining adequate magnesium levels is crucial for cardiac function.
  • Hypomagnesaemia can increase the risk of arrhythmias post-surgery.

Purpose of the Study:

  • To investigate the effect of intraoperative magnesium administration on plasma magnesium levels.
  • To assess the impact of magnesium on the incidence of arrhythmias after coronary revascularization.
  • To evaluate changes in corrected QT (QTcorr) intervals in response to magnesium supplementation.

Main Methods:

  • A randomized controlled trial involving 20 patients undergoing coronary revascularization without cardioplegic arrest.

Related Experiment Videos

  • Patients received either magnesium chloride (16 mmol) or a saline placebo during cardiopulmonary bypass.
  • Plasma and urinary magnesium levels, ECGs, and QTcorr intervals were monitored for 24 hours post-operation.

    • Main Results:

    • The magnesium group maintained normal plasma magnesium levels, unlike the control group which experienced hypomagnesaemia.
    • Urinary magnesium excretion was 58% in the first 24 hours in the magnesium group.
    • The incidence of ventricular arrhythmias was significantly lower in the magnesium group (22%) compared to the control group (63%).
    • No significant differences in QTcorr intervals were observed between the groups.

    Conclusions:

    • Intraoperative magnesium administration effectively prevents hypomagnesaemia during cardiopulmonary bypass.
    • Magnesium supplementation is associated with a reduced incidence of post-coronary revascularization arrhythmias.
    • Magnesium does not appear to significantly alter QTcorr intervals in this patient population.