The Coagulation Changes Induced by Rapid In Vivo Crystalloid Infusion Are Attenuated When Magnesium Is Kept at the Upper Limit of Normal

Abstract

Rapid hemodilution-induced coagulation may be partially due to decreased magnesium, and the effect is attenuated by maintaining magnesium at the upper limit of normal. Crystalloid resuscitation fluids should possibly contain higher magnesium levels, around 3 mmol/L.

The effect of crystalloid infusion on body water content and intra-abdominal pressure in patients undergoing orthopedic surgery under spinal anesthesia

“…It is worth noting that some authors observed hypercoagulation following crystalloid infusion. 20,21 A rapid infusion of crystalloids increases coagulative activity following hemodilution in healthy volunteers. 20 In vitro studies also document an increase in hypercoagulation measured by thrombelastography following different types of crystalloids.…”

“…20,21 A rapid infusion of crystalloids increases coagulative activity following hemodilution in healthy volunteers. 20 In vitro studies also document an increase in hypercoagulation measured by thrombelastography following different types of crystalloids. 21,22 Interestingly, this effect seems to depend on blood magnesium concentration.…”

“…21,22 Interestingly, this effect seems to depend on blood magnesium concentration. 20 Ruttmann et al showed that a rapid infusion of crystalloids decreased serum magnesium concentration to the lower limits of norms and increased coagulation in healthy volunteers, when magnesium supplementation attenuated these disturbances. 20 Significant hypercoagulation has also been reported in patients receiving liberal perioperative fluid therapy 24 and 48 h after surgery.…”

Serum Magnesium Levels in Aortic and Mitral Valve Replacement Surgeries

“…It has also been proved that in situation of rapid IV fluid infusion, maintaining the magnesium at the upper limit of normal value attenuates rapid hemodilution-induced coagulation change due to decreased magnesium level in healthy volunteers. 7 There were also some studies that magnesium interrupted platelet aggregation and adhesion so magnesium sulphate administration induced hypo coagulation state. 8,9 The aim of the present study was to determine the serum may level three days postoperatively in Mitral valve repair and replacement surgeries.…”

Stress repair mechanism activity explains inflammation and apoptosis

“…Crystalloids, colloids, and starch solutions briefly dilute coagulation precursors and enzymes, alter blood turbulence, and exaggerate blood pressure, which conveys the misleading impression that they improve cardiac output [384,687,688]. DIC removes red cells from circulation, causing anemia that exaggerates blood turbulence and inhibits coagulation [457].…”