Magnesium supplementation during cardiopulmonary bypass to prevent junctional ectopic tachycardia after pediatric cardiac surgery: a randomized controlled study
Manrique AM, Arroyo M, Lin Y, El Khoudary SR, Colvin E, Lichtenstein S, Chrysostomou C, Orr R, Jooste E, Davis P, Wearden P, Morell V, Munoz R
The Journal of thoracic and cardiovascular surgery · 39 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Organización sin fines de lucro
- Intensive Care Society
- Universidad u hospital
- Children's Hospital of Pittsburgh
Según 2 financiadores declarados.
Publicación
- Publicado
- 2009-10-13 · J Thorac Cardiovasc Surg · vol. 139 · número 1 · págs. 162–169.e2
- Editorial
- Elsevier BV
- Citado
- 72 citas · más que el 94% de estudios similares · 4.6× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 29 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Magnesium in Health and Disease · Cardiac and Coronary Surgery Techniques · Congenital Heart Disease Studies
- Palabras clave
- magnesium sulfate, magnesium supplementation, cardiopulmonary bypass, junctional ectopic tachycardia, hypomagnesemia, pediatric cardiac surgery, ionized magnesium, dose-response relationship, arrhythmia prevention, Pediatric Risk of Mortality score, length of hospital stay
- MeSH
- humans, tachycardia, ectopic junctional, postoperative complications, magnesium, magnesium sulfate, anti-arrhythmia agents, cardiopulmonary bypass, double-blind method, adolescent, child, child, preschool, infant, infant, newborn, female, male
13 autores
- Ana Maria Manrique🇺🇸University of Pittsburgh; Children's Hospital of Pittsburgh
- Margarita Arroyo🇺🇸University of Pittsburgh; Children's Hospital of Pittsburgh
- Yan Lin🇺🇸University of Pittsburgh
- Samar R. El Khoudary🇺🇸University of Pittsburgh
- Erin L. Colvin🇺🇸University of Pittsburgh; Children's Hospital of Pittsburgh
- Steven Lichtenstein🇺🇸University of Pittsburgh; Children's Hospital of Pittsburgh
- Constantinos Chrysostomou🇺🇸University of Pittsburgh; Children's Hospital of Pittsburgh
- Richard A. Orr🇺🇸University of Pittsburgh; Children's Hospital of Pittsburgh
- Edmund H. Jooste🇺🇸University of Pittsburgh; Children's Hospital of Pittsburgh
- Peter J. Davis🇺🇸University of Pittsburgh; Children's Hospital of Pittsburgh
- Peter D. Wearden🇺🇸University of Pittsburgh; Children's Hospital of Pittsburgh
- Victor O. Morell🇺🇸University of Pittsburgh; Children's Hospital of Pittsburgh
- Ricardo A. Munoz🇺🇸 · autor de correspondenciaUniversity of Pittsburgh; Children's Hospital of Pittsburgh
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objectives
We analyzed the role of magnesium sulfate (MgSO(4)) supplementation during cardiopulmonary bypass in pediatric patients undergoing cardiac surgery, assessing the incidence of hypomagnesemia and the incidence of junctional ectopic tachycardia.
Methods
We performed a randomized, double-blind, controlled trial in 99 children. MgSO(4) or placebo was administered during the rewarming phase of cardiopulmonary bypass: group 1, placebo group (29 patients); group 2, 25 mg/kg of MgSO(4) (30 patients); and group 3, 50 mg/kg of MgSO(4) (40 patients).
Results
At the time of admission to the cardiac intensive care unit, groups receiving MgSO(4) had significantly greater levels of ionized magnesium (group 1, 0.51 + or - 0.07; group 2, 0.57 + or - 0.09; group 3, 0.59 + or - 0.09). Hypomagnesemia before bypass was common (75%-86.2%) and not significantly different among the groups. The proportion of hypomagnesemia decreased significantly at admission to the cardiac intensive care unit in groups receiving MgSO(4) (group 1, 77.8%; group 2, 63%; group 3, 47.4%). Patients receiving placebo (group 1) had a significantly greater occurrence of junctional ectopic tachycardia than groups receiving MgSO(4) (group 1, n = 5 [17.9%]; group 2, n = 2 [6.7%]; group 3, n = 0 [0%]). Age (4), and history of cardiac failure were associated with junctional ectopic tachycardia. None of the patients with those characteristics in group 3 had junctional ectopic tachycardia. No association was found between study groups and the Pediatric Risk of Mortality score or length of stay in the cardiac intensive care unit.
Conclusions
Supplementation with MgSO(4) during cardiopulmonary bypass seems to reduce the incidence of hypomagnesemia and junctional ectopic tachycardia at admission to the cardiac intensive care unit. This effect seems to be dose related.
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