Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/23470
Title: Continuous Magnesium Infusion to Prevent Atrial Fibrillation After Cardiac Surgery: A Sequential Matched Case-Controlled Pilot Study.
Austin Authors: Osawa, Eduardo A;Cutuli, Salvatore L ;Cioccari, Luca;Bitker, Laurent;Peck, Leah ;Young, Helen ;Hessels, Lara;Yanase, Fumitaka ;Fukushima, Julia T;Hajjar, Ludhmila A;Seevanayagam, Siven ;Matalanis, George ;Eastwood, Glenn M ;Bellomo, Rinaldo 
Affiliation: Department of Anesthesiology and Intensive Care, Fondazione Policlinico Universitario A. Gemelli, Universita Cattolica del Sacro Cuore, Rome, Italy
Australian and New Zealand Intensive Care Research Centre, Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia
Department of Cardiology, Heart Institute (InCor), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Centre for Integrated Critical Care, School of Medicine, The University of Melbourne, Melbourne, Australia
Department of Critical Care, University of Groningen, University Medical Center, Groningen, The Netherlands..
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Department of Cardiac Surgery, Austin Health, Heidelberg, Victoria, Australia
Department of Intensive Care Medicine, University Hospital, University of Bern, Bern, Switzerland
Department of Cardiology, Heart Institute (InCor), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Issue Date: Nov-2020
metadata.dc.date: 2020-05-21
Publication information: Journal of Cardiothoracic and Vascular Anesthesia 2020; 34(11): 2940-2947
Abstract: The authors aimed to test whether a bolus of magnesium followed by continuous intravenous infusion might prevent the development of atrial fibrillation (AF) after cardiac surgery. Sequential, matched, case-controlled pilot study. Tertiary university hospital. Matched cohort of 99 patients before and intervention cohort of 99 consecutive patients after the introduction of a continuous magnesium infusion protocol. The magnesium infusion protocol consisted of a 10 mmol loading dose of magnesium sulphate followed by a continuous infusion of 3 mmol/h over a maximum duration of 96 hours or until intensive care unit discharge. The study groups were balanced except for a lower cardiac index in the intervention cohort. The mean duration of magnesium infusion was 27.93 hours (95% confidence interval [CI]: 24.10-31.76 hours). The intervention group had greater serum peak magnesium levels: 1.72 mmol/L ± 0.34 on day 1, 1.32 ± 0.36 on day 2 versus 1.01 ± 1.14 and 0.97 ± 0.13, respectively, in the control group (p < 0.01). Atrial fibrillation occurred in 25 patients (25.3%) in the intervention group and 40 patients (40.4%) in the control group (odds ratio 0.49, 95% CI, 0.27-0.92; p = 0.023). On a multivariate Cox proportional hazards model, the hazard ratio for the development of AF was significantly less in the intervention group (hazard ratio 0.45, 95% CI, 0.26-0.77; p = 0.004). The magnesium delivery strategy was associated with a decreased incidence of postoperative AF in cardiac surgery patients. These findings provide a rationale and preliminary data for the design of future randomized controlled trials.
URI: http://ahro.austin.org.au/austinjspui/handle/1/23470
DOI: 10.1053/j.jvca.2020.04.006
ORCID: 0000-0003-3859-3537
0000-0002-3019-8383
0000-0003-4993-427X
0000-0002-1650-8939
PubMed URL: 32493662
Type: Journal Article
Subjects: cardiac surgery
case-control
intensive care
magnesium
sequential matching
Appears in Collections:Journal articles

Show full item record

Page view(s)

16
checked on May 15, 2021

Google ScholarTM

Check


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.