The neuroprotective effect of magnesium sulphate during iatrogenically-induced ventricular fibrillation

Abstract

We studied the neuroprotective effect of magnesium sulphate (MgSO 4) administered before ventricular fibrillation was induced for internal cardioverter defibrillator threshold testing, and continued during reperfusion. Methods: with the intention of increasing serum magnesium (Mg) to >1.2 mmol/L, 15 patients received 16 mmol of MgSO 4 , IV, followed by 5 mmol over two hours. Fifteen patients received placebo. Serum neuron-specific enolase (NSE) was assessed, as well as pre-and postoperative neurocognitive function. Results: NSE increased in all patients, reaching a peak at 24 hours. The target Mg level was maintained throughout surgery in only nine of the Mg patients, and mainly in those with low lean body mass (LBM). In these patients, increased Mg levels were related to altered NSE release (P<0.05). NSE increased when serum Mg dropped to <1.2 mmol/L, finally exceeding levels of inadequately or untreated patients. Neurocognitive function after surgery was similar between groups. Conclusions: insufficient dosing could account for our results, as NSE release could be inhibited by Mg >1.2 mmol/L. For neuroprotection, the Mg dosage should be adjusted according to LBM and infusion be extended to >2 hours.

<p>A Novel Diagnostic Prediction Model for Vestibular Migraine</p>

“…34 Mg 2+ deficiency leads to central neurotransmitter 5-HT and the release of adrenaline activates abnormal excitation of cortical neurons. 35 In addition, Mg 2+ can significantly inhibit the vasoconstrictor activity of catecholamine, histamine, and other neurotransmitters. 36 These evidences suggest that Mg 2+ may play an important role in the development of VM.…”

The role of magnesium sulfate in the intensive care unit

“…These injuries include stroke, aneurysmal subarachnoid hemorrhage (ASAH), and traumatic brain injuries (Afshari et al, 2013[2]; Akdemir et al, 2009[6]; Bradford et al, 2013[18]; Chan et al, 2005[23]; Chen et al, 2015[25]; Chen and Carter, 2011[27]; Dabbagh et al, 2006[30]; Dorhout Mees et al, 2012[33]; Friedlich et al, 2009[42]; Gao et al, 2013[45]; Gonzalez-Garcia et al, 2012[49]; Hassan et al, 2012[58]; James et al, 2009[69]; Jiang et al, 2017[71]; Johnson et al, 1993[72]; Kahraman et al, 2003[75]; Kidwell et al, 2009[79]; Kumar et al, 2015[85]; Lamers et al, 2003[87]; Lampl et al, 2001[88]; Mirrahimi et al, 2015[107]; Mousavi et al, 2004[109], 2010[110]; Muir and Lees, 1995[112]; Muir et al, 2004[113]; Muroi et al, 2008[114]; Rahimi-Bashar et al, 2017[122]; Rinosl et al, 2013[125]; Saver et al, 2015[132]; Selvaraj and Syed, 2014[136]; Singh et al, 2012[144]; Sleeswijk et al, 2008[146]; Stippler et al, 2006[148]; van den Bergh et al, 2005[156]; van Norden et al, 2005[157]; Veyna et al, 2002[158]; Wang et al, 2012[163]; Westermaier et al, 2010[166]; Wong et al, 2010[171]; Zafar et al, 2014[172]; Zhao et al, 2016[174]; Zhu et al, 2004[175]). …”

“…Effect of MgSO 4 on biomarkers in different neuropathies has been assessed in several studies (Bharosay et al, 2012[14]; Chan et al, 2005[23]; Friedlich et al, 2009[42]; Gao et al, 2013[45]; Gonzalez-Garcia et al, 2012[49]; Hassan et al, 2012[58]; James et al, 2009[69]; Johnson et al, 1993[72]; Lamers et al, 2003[87]; Mirrahimi et al, 2015[107]; Rahimi-Bashar et al, 2017[122]; Rinosl et al, 2013[125]). MgSO 4 was shown to decrease S100B levels with little side effects (Hassan et al, 2012[58]).…”