Magnesium sulfate therapy after cardiac surgery: a before-and-after study comparing strategies involving bolus and continuous infusion.

摘要: BACKGROUND Magnesium therapy may reduce the risk of atrial fibrillation after cardiac surgery. However, studies are heterogeneous in relation to dosage and method delivery no have directly compared biochemical effect different strategies. AIMS We conducted a before-and-after study compare effects two strategies magnesium METHODS prospective interventional study. enrolled patients admitted intensive care unit (ICU) surgery with history renal failure. The before period consisted single 20 mmol sulfate bolus administered over one hour. comprised 10 loading dose hour followed by continuous infusion at 3 mmol/h for 12 hours. measured serum urine levels baseline (T0), end (T1), 6 (T2) hours intervention (T3). RESULTS 60 (30 each group) similar characteristics. In period, had higher peak level T1 (1.88 ± 0.06 v 1.59 0.04 mmo/L; P < 0.001) period. hours, significantly (1.61 1.29 0.26 mmol/L; this remained (1.70 0.05 1.17 0.02; 0.001), leading increased time-weighted magnesaemia (P 0.001). These changes occurred despite urinary concentration, fractional excretion magnesium, clearance, which paralleled CONCLUSIONS strategy achieved more sustained moderately elevated concentration comparison bolus, losses magnesium. Further required assess extended infusion.