Magnesium status and magnesium therapy in cardiac surgery: A systematic review and meta-analysis focusing on arrhythmia prevention

Fairley, Jessica; Zhang, Ling; Glassford, Neil J; Bellomo, Rinaldo

doi:10.1016/j.jcrc.2017.05.038

Cited by 54 publications

(27 citation statements)

References 54 publications

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“…This was most common in patients with AF or flutter. It has been reported that Mg may have a role in AF prevention in the postoperative cardiothoracic surgery setting . However, there is conflicting evidence regarding the efficacy of Mg in AF treatment in the ED and other settings .…”

Section: Discussionmentioning

confidence: 99%

Utility of calcium, magnesium and phosphate testing in the emergency department

Date

Smith²,

Spencer

et al. 2019

Emerg Medicine Australasia

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Objective To determine how frequently calcium (Ca), magnesium (Mg) and phosphate (PO4) tests change ED patient management. Methods We undertook a retrospective observational study in an Australian tertiary referral ED. We enrolled adult patients (aged ≥18 years) who presented between 1 January and 30 June 2017 and who had a serum Ca, Mg or PO4 test ordered and completed during their ED stay. Patient symptoms, medical history, electrolyte levels and ED management changes were extracted from the electronic medical record. Results Of the 33 120 adults presented during the study period, 1716 (5.2%, 95% confidence interval [CI] 5.0–5.4) had at least one Ca, Mg or PO4 test completed in the ED. This included 4776 individual electrolyte tests, of which 776 (16.2%, 95% CI 15.2–17.3) were abnormal. Fifty‐six (7.2% [95% CI 5.5–9.3] of patients with abnormal tests, 1.2% [95% CI 0.9–1.5] of all tests) tests were associated with a change in ED management. Twenty‐six out of 1683 (1.5%) Ca levels were low with six (23.1%) management changes; 203 (12.1%) were high with 10 (4.9%) management changes. One hundred and twenty‐eight out of 1579 (8.1%) Mg levels were low with 33 (25.8%) management changes; 30 (1.9%) were high with no management changes. Two hundred and twenty‐five out of 1514 (14.9%) PO4 levels were low with six (2.7%) management changes; 164 (10.8%) were high with one (0.6%) management change. Fifty (2.9%) patients had management changes despite normal electrolyte levels. Conclusion Ca, Mg and PO4 testing is common. However, the yield of clinically significant abnormal levels is low and patient management is rarely changed. Testing of these electrolytes needs to be rationalised.

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Section: Discussionmentioning

confidence: 99%

Utility of calcium, magnesium and phosphate testing in the emergency department

Date

Smith²,

Spencer

et al. 2019

Emerg Medicine Australasia

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“…The intravenous administration of magnesium has proven to be safe in any case [33,38], and it has already been used as an effective therapy in the torsade de pointes [39]. The effectiveness of magnesium supplementation in the prevention of postoperative supraventricular arrhythmias seems to be the same for thoracic surgery [40].…”

Section: Ionized Vs Total Magnesium Levels In the Perioperative Settingmentioning

confidence: 99%

Ionized or Total Magnesium Levels, What Should We Measure?

Scarpati¹,

Baldassarre²,

Oliva³

et al. 2020

Preprint

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Monitoring and measuring magnesium (Mg) values are essential to prevent the development of numerous complications in perioperative medicine and critically ill patients. Although previous studies suggest that measuring free ionized magnesium (iMg) is more useful for estimating Mg status, clinicians currently rely on measurement of total serum magnesium to determine if supplemental magnesium is needed. In this review, we analyzed the recent literature to decide whether it is better to measure ionized serum Mg or total serum Mg when assessing magnesium status, whether iMg predicts clinical outcome, and what are the difficulties in measuring serum iMg levels in intensive care patients and perioperative medicine.

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“…Durlach recommended that in order to maintain healthy relations total dietary Ca:Mg ratio should remain close to 2.0 [12]. Magnesium blocks the repolarization of Ca++ -channels therefore used as first choice drug in cardiac surgery for treatment of tachycardias, first of all atrial fibrillation [13]. Mg supplementation can modify the intracellular ratio of Ca:Mg which affects -as demonstrated by in vitro studies -physiological processes and cell proliferation [14].…”

Section: Magnesium the Indispensible Cationmentioning

confidence: 99%

Dietary Magnesium Supplements – Is there any Problem?

Télessy¹

2018

jnhfs

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Magnesium status and magnesium therapy in cardiac surgery: A systematic review and meta-analysis focusing on arrhythmia prevention

Cited by 54 publications

References 54 publications

Utility of calcium, magnesium and phosphate testing in the emergency department

Utility of calcium, magnesium and phosphate testing in the emergency department

Ionized or Total Magnesium Levels, What Should We Measure?

Dietary Magnesium Supplements – Is there any Problem?

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