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Rivista di Chirurgia Cardiaca, Vascolare e Toracica

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The Journal of Cardiovascular Surgery 2001 February;42(1):37-42

lingua: Inglese

Plasma magnesium in patients submitted to cardiac surgery and its influence on perioperative morbidity

Parra L., Fita G., Gomar C., Rovira I., Marín J. L. *

From the Department of Anaesthesiology
*Department Central Laboratories Hospital Clinic i Provincial University of Barcelona, Barcelona, Spain


Background. To deter­mine the chang­es in mag­ne­sae­mia in car­diac sur­gi­cal ­patients sub­mit­ted to car­di­o­pul­mo­nary ­bypass (CPB) and ­their influ­ence on per­i­op­er­a­tive mor­bid­ity.
Methods. Setting: the car­di­o­vas­cu­lar sur­gery depart­ment of a uni­ver­sity hos­pi­tal. Patients: 60 ­patients of ­both sex­es, ­mean age 60±12 yrs, oper­at­ed on con­sec­u­tive­ly for myo­car­dial revas­cu­lar­iza­tion or ­valve replace­ment. Interventions: plas­ma Mg2+ lev­els ­were meas­ured pre­op­er­a­tive­ly, dur­ing CPB, postCPB and through­out the ­first 24 hrs ­after oper­a­tion. Preoperative plas­ma Mg2+ lev­els of ­these ­patients ­were com­pared ­with ­those of 15 non-car­diac sur­gi­cal ­patients and 11 ­healthy vol­un­teers.
Results. ­Mean val­ues of Mg2+ sim­i­lar in the ­three pop­u­la­tions ­although in the ­group of car­diac ­patients the num­ber of hypo­mag­ne­saem­ic ­patients was sig­nif­i­cant­ly high­er (16 ­patients=26.6%). In ­these 16 ­patients, pre­op­er­a­tive hypo­mag­ne­sae­mia had a sta­tis­ti­cal­ly sig­nif­i­cant rela­tion­ship ­with the pre­op­er­a­tive treat­ment ­with ­beta-block­ers and pre­vi­ous his­to­ry of arrhyth­mi­as (p<0.05). A pro­gres­sive sta­tis­ti­cal­ly sig­nif­i­cant ­decrease of Mg2+ was ­observed through­out the sur­gery ­that ­remained low at 24 ­hours post­op­er­a­tive­ly (p<0.05). Normomagnesemic ­patients need­ed sig­nif­i­cant­ly ­more ­shocks and electri­cal ener­gy to ­obtain ­heart defib­ril­la­tion ­after CPB. The inci­dence of ­both post­op­er­a­tive arrhyth­mi­as and post­op­er­a­tive low car­diac ­index (<2.5 L.m2) was sta­tis­ti­cal­ly sig­nif­i­cant­ly ­more fre­quent in hypo­mag­ne­saem­ic ­patients (p<0.05).
Conclusions. Preoperative hypo­mag­ne­sae­mia was ­more fre­quent in ­this ­small sam­ple of car­diac sur­gi­cal ­patients ­than in non-car­diac sur­gi­cal ­patients and was relat­ed to pre­op­er­a­tive treat­ment ­with ­β-block­ers. Hypomagne-saemia ­caused by CPB per­sist­ed 24 hrs ­after oper­a­tion and was asso­ciat­ed ­with high­er inci­dence of ­both post­op­er­a­tive arrhyth­mi­as and low car­diac ­index.

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