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Plasma digoxin and magnesium concentration in open heart surgery
The Journal of Cardiovascular Surgery
|March 1, 1979
Summary
Cardiopulmonary bypass surgery led to decreased digoxin and significant hypomagnesemia in patients. Standard magnesium replacement during surgery was insufficient to prevent low magnesium levels post-procedure.
Area of Science:
- Cardiovascular Surgery
- Clinical Chemistry
- Anesthesiology
Background:
- Cardiopulmonary bypass (CPB) is a critical procedure in cardiac surgery.
- Maintaining electrolyte balance during CPB is essential for patient outcomes.
- Previous studies have indicated potential electrolyte shifts during CPB.
Purpose of the Study:
- To investigate plasma concentration changes of key electrolytes and digoxin during and after CPB.
- To evaluate the effectiveness of standard magnesium supplementation during CPB.
Main Methods:
- Plasma samples were collected from 12 patients before, during, and 24 hours after CPB surgery.
- Concentrations of digoxin, magnesium, potassium, and calcium were measured.
- Magnesium was added to the CPB circuit in 7 patients.
Main Results:
- Digoxin levels consistently decreased during CPB.
- A significant decrease in plasma magnesium levels was observed during CPB, persisting for 24 hours.
- Potassium and calcium levels were maintained within the high normal range through exogenous administration.
- Additional magnesium in the CPB circuit did not prevent hypomagnesemia.
Conclusions:
- CPB surgery is associated with a decrease in digoxin levels and significant hypomagnesemia.
- Standard magnesium replacement protocols during CPB may be inadequate.
- More aggressive magnesium administration during CPB might be necessary to avoid hypomagnesemia.