Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/16718
Title: Magnesium status and magnesium therapy in cardiac surgery: a systematic review and meta-analysis focusing on arrhythmia prevention
Authors: Fairley, Jessica L
Zhang, Ling
Glassford, Neil J
Bellomo, Rinaldo
Date of Publication: Dec-2017
Citation: Journal of Critical Care 2017; 42: 69-77
Abstract: PURPOSE: To investigate magnesium as prophylaxis or treatment of postoperative arrhythmias in cardiac surgery (CS) patients. To assess impact on biochemical and patient-centered outcomes. MATERIALS AND METHODS: We searched MEDLINE, CENTRAL and EMBASE electronic databases from 1975 to October 2015 using terms related to magnesium and CS. English-Language RCTs were included involving adults undergoing CS with parenterally administered magnesium to treat or prevent arrhythmias, compared to control or standard antiarrythmics. We extracted incidence of postoperative arrhythmias, termination following magnesium administration and secondary outcomes (including mortality, length of stay, hemodynamic parameters, biochemistry). RESULTS: Thirty-five studies were included, with significant methodological heterogeneity. Atrial fibrillation (AF) was most commonly reported, followed by ventricular, supraventricular and overall arrhythmia frequency. Magnesium appeared to reduce AF (RR 0.69, 95% confidence interval (95%CI) 0.56-0.86, p=0.002), particularly postoperatively (RR 0.51, 95%CI 0.34-0.77, p=0.003) for longer than 24h. Maximal benefit was seen with bolus doses up to 60mmol. Magnesium appeared to reduce ventricular arrhythmias (RR=0.46, 95%CI 0.24-0.89, p=0.004), with a trend to reduced overall arrhythmias (RR=0.80, 95%CI 0.57-1.12, p=0.191). We found no mortality effect or significant increase in adverse events. CONCLUSIONS: Magnesium administration post-CS appears to reduce AF without significant adverse events. There is limited evidence to support magnesium administration for prevention of other arrhythmias.
URI: http://ahro.austin.org.au/austinjspui/handle/1/16718
DOI: 10.1016/j.jcrc.2017.05.038
PubMed URL: https://www.ncbi.nlm.nih.gov/pubmed/28688240
Type: Journal Article
Subject: Arrhythmia
Biochemical outcome
Critical illness
Electrolyte disturbance
Intensive care
Magnesium
Magnesium administration
Magnesium therapy
Mortality
Patient-centered outcome
Appears in Collections:Journal articles

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