Original ArticlePharmacokinetics of Magnesium Bolus Therapy in Cardiothoracic Surgery
Section snippets
Study Inclusion Criteria
Inclusion criteria included (1) admission to the ICU after elective cardiac surgery and (2) a clinician’s decision to administer intravenous magnesium. Exclusion criteria included (1) pre-existing or acute renal failure and (2) a serum magnesium level ≥1.5 mmol/L at baseline.
Austin Health Human Research Ethics Committee approval was attained on June 23, 2016 (reference number: LNR/15/Austin/306). All included patients gave written consent to participate in the study.
Participants
The study included 20
Results
The study included 20 patients admitted to a tertiary ICU from August 1 to 31, 2016. The baseline characteristics of included patients are shown in Table 1. All patients included gave written consent to participate in the study. No further magnesium boluses, oral or intravenous, were administered after the study medication.
Crystalloids (median 1,500 mL, IQR 1,000-2,625) were used for intraoperative management rather than colloid infusions (median 0). Isotonic cardioplegic solution (16 mmol/L of
Key Findings
This study provides the first analysis of the effect of intravenous magnesium on serum and urinary magnesium concentrations in ICU patients after cardiothoracic surgery. The results demonstrate that 20 mmol of magnesium sulfate concomitantly increases the serum magnesium concentration and magnesium urinary excretion and that the volume of distribution of magnesium approximates 0.3 L/kg of body weight. Moreover, the magnesium serum concentration returned to near pretreatment levels within 12
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Cited by (13)
A pilot study of the pharmacokinetics of continuous magnesium infusion in critically ill patients
2022, Critical Care and ResuscitationContinuous Magnesium Infusion to Prevent Atrial Fibrillation After Cardiac Surgery: A Sequential Matched Case-Controlled Pilot Study
2020, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :In addition, the daily amount of 5 g corresponded to less than one-third of the daily amount prescribed in the authors’ infusion protocol. The authors recently have observed that a bolus of magnesium therapy after cardiac surgery has short-lived effects on blood levels due to urinary excretion.20 Thus, the lack of protective effect against AF reported by some studies31-34 may have been related to a non-sustained delivery method.
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2019, Journal of Cardiothoracic and Vascular AnesthesiaPharmacokinetics of Magnesium in Cardiac Surgery: Implications for Prophylaxis Against Atrial Fibrillation
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2018, Journal of Critical CareCitation Excerpt :In order to study such targets and their effect on arrhythmias, however, it is crucial to understand the pharmacokinetics of intravenous magnesium administration in cardiac surgery patients so that such targets can be reliably achieved. Recently, intravenous bolus magnesium therapy was shown to fail to achieve a sustained increase of serum magnesium concentration due to the short half-life and complete renal excretion within 12 h [10]. The findings of this study, however, suggested that a combined approach of bolus dose followed by a continuous infusion, at an hourly dose based on renal elimination, may provide stable magnesium levels in the moderately elevated range.
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