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Title: Pharmacokinetics of Magnesium Bolus Therapy in Cardiothoracic Surgery
Austin Authors: Biesenbach, Peter;Mårtensson, Johan;Lucchetta, Luca;Bangia, Ravi;Fairley, Jessica;Jansen, Irmelin;Matalanis, George ;Bellomo, Rinaldo 
Affiliation: Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
School of Public Health and Preventive Medicine, Monash University, Prahran, Victoria, Australia
Department of Cardiac Surgery, Austin Hospital, Heidelberg, Melbourne, Australia
Intensive Care Unit, Warringal Private Hospital, Heidelberg, Victoria, Australia
Department of Anaesthesia and Perioperative Medicine, Box Hill Hospital, Box Hill, Victoria, Australia
University of Melbourne, Melbourne, Australia
Cardiac Surgery Services, Warringal Private Hospital, Heidelberg, Victoria, Australia
Issue Date: Jun-2018
Date: 2017-09-01
Publication information: Journal of Cardiothoracic and Vascular Anesthesia 2018; 32(3): 1289-1294
Abstract: To investigate the pharmacokinetics of a 20 mmol magnesium bolus in regards to serum and urinary magnesium concentration, volume of distribution, and half-life. Prospective, experimental study. A university-affiliated teaching hospital. Twenty consecutive cardiac surgery patients treated with magnesium bolus therapy for prevention of arrhythmia. A 20-mmol bolus of magnesium sulfate was administered intravenously. Median magnesium levels increased from 1.04 (interquartile range 0.94-1.23) mmol/L to 1.72 (1.57-2.14) mmol/L after 60 minutes of magnesium infusion (p < 0.001) but decreased to 1.27 (1.21-1.36) and 1.16 (1.11-1.21) mmol/L after 6 and 12 hours, respectively. Urinary magnesium concentration increased from 6.3 (4.2-14.5) mmol/L to 19.1 (7.4-34.5) mmol/L after 60 minutes (p < 0.001), followed by 22.7 (18.4-36.7) and 15 (8.4-19.7) mmol/L after 6 and 12 hours, respectively. Over the 12-hour observation period, the cumulative urinary magnesium excretion was 19.1 mmol (95.5% of the dose given). The median magnesium clearance was 10 (4.7-15.8) mL/min and increased to 14.9 (3.8-20.7; p = 0.934) mL/min at 60 minutes. The estimated volume of distribution was 0.31 (0.28-0.34) L/kg. Magnesium bolus therapy after cardiac surgery leads to a significant but short-lived increase of magnesium serum concentration due to renal excretion and distribution, and the magnesium balance is neutral after 12 hours.
DOI: 10.1053/j.jvca.2017.08.049
ORCID: 0000-0001-8739-7896
Journal: Journal of Cardiothoracic and Vascular Anesthesia
PubMed URL: 29169799
Type: Journal Article
Subjects: arrhythmia
atrial flutter
cardiac surgery
intensive care
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