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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES CARDIAC PAPERS
The Journal of Cardiovascular Surgery 2001 Febbraio;42(1):37-42
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.