Magnesium Administration and Dysrhythmias After Cardiac Surgery

England, Michael R.; Gordon, George; Salem, Michael; Chernow, Bart

doi:10.1001/jama.1992.03490170067027

Cited by 202 publications

(28 citation statements)

References 44 publications

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“…Hypomagnesemia has been observed after cardiac surgery [8,9], and most studies have shown that the administration of magnesium decreases the incidence of AA after cardiovascular surgery [10-13]. But the effectiveness of magnesium has been more controversial, because that evidence comes from multiple small, underpowered trials, with conflicting results, probably because of differences in study design, including the using of beta-blockers, although a recent meta-analysis concluded that magnesium is an effective prophylactic agent for prevention of postoperative AF [14].…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis of randomized controlled trials on magnesium in addition to beta-blocker for prevention of postoperative atrial arrhythmias after coronary artery bypass grafting

Wang

Zhu

et al. 2013

BMC Cardiovasc Disord

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BackgroundAtrial arrhythmia (AA) is the most common complication after coronary artery bypass grafting (CABG). Only beta-blockers and amiodarone have been convincingly shown to decrease its incidence. The effectiveness of magnesium on this complication is still controversial. This meta-analysis was performed to evaluate the effect of magnesium as a sole or adjuvant agent in addition to beta-blocker on suppressing postoperative AA after CABG.MethodsWe searched the PubMed, Medline, ISI Web of Knowledge, Cochrane library databases and online clinical trial database up to May 2012. We used random effects model when there was significant heterogeneity between trials and fixed effects model when heterogeneity was negligible.ResultsFive randomized controlled trials were identified, enrolling a total of 1251 patients. The combination of magnesium and beta-blocker did not significantly decrease the incidence of postoperative AA after CABG versus beta-blocker alone (odds ratio (OR) 1.12, 95% confidence interval (CI) 0.86-1.47, P = 0.40). Magnesium in addition to beta-blocker did not significantly affect LOS (weighted mean difference −0.14 days of stay, 95% CI −0.58 to 0.29, P = 0.24) or the overall mortality (OR 0.59, 95% CI 0.08-4.56, P = 0.62). However the risk of postoperative adverse events was higher in the combination of magnesium and beta-blocker group than beta-blocker alone (OR 2.80, 95% CI 1.66-4.71, P = 0.0001).ConclusionsThis meta-analysis offers the more definitive evidence against the prophylactic administration of intravenous magnesium for prevention of AA after CABG when beta-blockers are routinely administered, and shows an association with more adverse events in those people who received magnesium.

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Section: Introductionmentioning

confidence: 99%

Meta-analysis of randomized controlled trials on magnesium in addition to beta-blocker for prevention of postoperative atrial arrhythmias after coronary artery bypass grafting

Wang

Zhu

et al. 2013

BMC Cardiovasc Disord

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“…Causes of Mg loss due to redistribution of Mg and endocrine disorders include acute respiratory alkalosis, administration of epinephrine, alcoholic ketoacidosis, blood transfusion, diabetic ketoacidosis, hyperaldosteronism, hyperparathyroidism, hyperthyroidism, hungry bone syndrome, and syndrome of inappropriate antidiuretic hormone (al-Ghamdi et al, 1994[8]; Aziz et al, 1996[9]; England et al, 1992[38]; Martin et al, 2009[99]; McLellan et al, 1984[104]; Shane and Flink, 1991[140]; Whyte et al, 1987[168]). Other causes include cardiopulmonary bypass, hypophosphatemia (chronic alcoholism), hypercalcemia/hypercalciuria, excessive sweating and severe burns (al-Ghamdi et al, 1994[8]; Kingston et al, 1986[80]; Martin et al, 2009[99]; Weglicki and Phillips, 1992[165]).…”

Section: Magnesium Deficiency In Icumentioning

confidence: 99%

The role of magnesium sulfate in the intensive care unit

Panahi

Mojtahedzadeh

Najafi

et al. 2017

EXCLI Journal; 16:Doc448; ISSN 1611-2156

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“…However magnesium supplementation has produced conflicting results. Magnesium supplementation should aim to achieve adequate magnesium blood levels [28, 29]. …”

Section: Pathophysiologymentioning

confidence: 99%

Postoperative Arrhythmias after Cardiac Surgery: Incidence, Risk Factors, and Therapeutic Management

Peretto

Durante

Limite

et al. 2014

Cardiology Research and Practice

175

110

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Arrhythmias are a known complication after cardiac surgery and represent a major cause of morbidity, increased length of hospital stay, and economic costs. However, little is known about incidence, risk factors, and treatment of early postoperative arrhythmias. Both tachyarrhythmias and bradyarrhythmias can present in the postoperative period. In this setting, atrial fibrillation is the most common heart rhythm disorder. Postoperative atrial fibrillation is often self-limiting, but it may require anticoagulation therapy and either a rate or rhythm control strategy. However, ventricular arrhythmias and conduction disturbances can also occur. Sustained ventricular arrhythmias in the recovery period after cardiac surgery may warrant acute treatment and long-term preventive strategy in the absence of reversible causes. Transient bradyarrhythmias may be managed with temporary pacing wires placed at surgery, but significant and persistent atrioventricular block or sinus node dysfunction can occur with the need for permanent pacing. We provide a complete and updated review about mechanisms, risk factors, and treatment strategies for the main postoperative arrhythmias.

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Magnesium Administration and Dysrhythmias After Cardiac Surgery

Cited by 202 publications

References 44 publications

Meta-analysis of randomized controlled trials on magnesium in addition to beta-blocker for prevention of postoperative atrial arrhythmias after coronary artery bypass grafting

Meta-analysis of randomized controlled trials on magnesium in addition to beta-blocker for prevention of postoperative atrial arrhythmias after coronary artery bypass grafting

The role of magnesium sulfate in the intensive care unit

Postoperative Arrhythmias after Cardiac Surgery: Incidence, Risk Factors, and Therapeutic Management

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