2022, Number 2
<< Back Next >>
Rev Mex Anest 2022; 45 (2)
Clinical trial: effect of magnesium sulfate on serum levels of lactate in the coronary sinus
Santiago-López J, León-Ramírez V, Gutiérrez-Sánchez DG
Language: Spanish
References: 21
Page: 87-91
PDF size: 256.47 Kb.
ABSTRACT
Introduction: Several methods have been proposed to control inflammation and to preserve the myocardium during cardiopulmonary bypass (CABG), including the administration of electrolytes such as magnesium (Mg
[2]+).
Objective: To compare the effect of using magnesium sulfate (MgSO
4) or a placebo before aortic clamping (AoC) on the serum levels of lactate in the coronary sinus in patients undergoing myocardial multivessel revascularization (MRV) with CABG.
Material and methods: A clinical assay was conducted with 52 patients undergoing MRV multivessel with CEC; the patients were randomized to receive a placebo (group I) or MgSO
4 (group II) before AoC, and blood samples were taken from the coronary sinus to quantify serum lactate at two different times: T
0: pre-AoC and T
1: before closing the chest. Statistical analysis was performed on Student's t-test and χ
2. A p < 0.05 was considered statistically significant. The data were processed with SPSS v-22.0.
Results: Serum levels of lactate in the coronary sinus post-AoC were lower in group II (2.967 ± 0.86 vs 2.154 ± 1.14), with significant differences (p = 0.006).
Conclusion: The use of MgSO
4 before AoC reduces serum lactate levels in the coronary sinus in patients undergoing MRV multivessel with CABG.
REFERENCES
Bro-Jeppesen J. Systemic inflammatory response and potential prognostic implications after out-of-hospital cardiac arrest: a substudy of the target temperature management trial. Crit Care Med. 2015;43:1223-1232.
Carrió ML, Ventura JL. ¿Does post-cardiac surgery magnesium supplementation improve outcome?. Magnesium Research. 2012;25:159-167.
Soave PM, Conti G. Magnesium and anaesthesia. Curr Drug Targets. 2009;10:734-743.
Quan W, Yin Y, Xi M, Zhou D, Zhu Y. Antioxidant properties of magnesium lithospermate B contribute to the cardioprotection against myocardialischemia/reperfusion injury in vivo and in vitro. J Tradit Chin Med. 2013;33:85-91.
Zhang CF, Luo WJ, Gao Y. Does magnesium-supplemented cardioplegia reduce cardiac injury? A meta-analysis of randomized controlled trials. J Card Surg. 2015;30:338-345.
Dabbagh A, Bastanifar E. The effect of intravenous magnesium sulfate on serum levels of N-terminal pro-brain natriuretic peptide (NT pro-BNP) in elective CABG with cardiopulmonary bypass. J Anesth. 2013;27:693-698.
Ferrari-Biscaglia RS. ¿Can we improve myocardial protection during ischaemic injury? Cardiology. 2016;135:14-26.
Taheri A, Haryalchi K. Effect of low-dose (single-dose) magnesium sulfate on postoperative analgesia in hysterectomy patients receiving balanced general anesthesia. Anesthesiol Res Pract. 2015;2015:306145.
Dabbagh A, Rajaei S. The effect of intravenous magnesium sulfate on acute postoperative bleeding in elective coronary artery bypass surgery. J Perianesth Nurs. 2010;25:290-295.
Das UN. Beneficial action of magnesium sulfate in bronchial asthma: how and why? Am J Emerg Med. 2016;34:1693-1694.
Tarasov EA, Blinov DV. Magnesium deficiency and stress: Issues of their relationship, diagnostic tests, and approaches to therapy. Ter Arkh. 2015;87:114-122.
Arias AM, Leyendecker V. Plasmatic pattern and clinical outcomes of lactic acid in heart transplantation. Arch Cardiol Mex. 2016;86:313-318.
Kapoor PM, Dhawan I. Lactate, endothelin and central venous oxygen saturation as predictors of mortality in patients with tetralogy of Fallot. Ann Card Anaesth. 2016;19:269-276.
Vida VL, Tessari C. The role of regional oxygen saturation using near-infrared spectroscopy and blood lactate levels as early predictors of outcome after pediatric cardiac surgery. Can J Cardiol. 2016;32:970-977.
Naghipour B, Faridaalaee G, Shadvar K, Bilehjani E, Khabaz AH, Fakhari S. Effect of prophylaxis of magnesium sulfate for reduction of postcardiac surgery arrhythmia: randomized clinical trial. Ann Card Anaesth. 2016;19:662-667.
Herrera-Alarcón V. Cirugía de revascularización coronaria sin pinzamiento aórtico, ventajas y resultados. Arch Cardiol Méx. 2006;S2:112-116.
Manrique AM, Arroyo M, Lin Y, El-Khoudary SR, Colvin E, Lichtenstein S, et al. Magnesium supplementation during cardiopulmonary bypass to prevent junctional ectopic tachycardia after pediatric cardiac surgery: a randomized controlled study. J Thorac Cardiovasc Surg. 2010;139:162-169.
Parastou A, Rajaei S. Acute effect of intravenous administration of magnesium sulfate on serum levels of interleukin-6 and tumor necrosis factor-α in patients undergoing elective coronary bypass graft with cardiopulmonary bypass. Anesth Pain Med. 2014;4:e16316.
Dodge-Khatami A, Miller OI, Anderson RH, Goldman AP, Gil-Jaurena JM, Elliott MJ, Tsang VT, De Leval MR. Surgical substrates of postoperative junctional ectopic tachycardia in congenital heart defects. J Thorac Cardiovasc Surg. 2002;123:624-630.
Klinger RY, Thunberg CA. Intraoperative magnesium administration does not reduce postoperative atrial fibrillation after cardiac surgery. Anesth Analg. 2015;121:861-867.
Hamid M, Kamal RS. Effect of single dose magnesium on arrhythmias in patients undergoing coronary artery bypass surgery. J Pak Med Assoc. 2008;58:22-27.