Hoshino Kenji, Ogawa Kiyoshi, Hishitani Takashi, Isobe Takeshi, Eto Yoshikatsu
Pediatric Cardiology, Saitama Children's Medical Center, 2100 Magome, Iwatsuki City, Saitama 339-8551, Japan.
J Am Coll Nutr. 2004 Oct;23(5):497S-500S. doi: 10.1080/07315724.2004.10719388.
Intravenous administration of magnesium sulphate (MgSO(4)) is a very effective and safe treatment for torsades de pointes (TdP) associated with acquired long QT syndrome (LQTS) in adults. Discussed here is the efficacy of MgSO(4) for TdP in children with congenital and acquired LQTS.
The optimal MgSO(4) dosage and serum magnesium (SMg) was determined in six consecutive children with TdP; four had congenital LQTS and two had acquired LQTS. A bolus injection of MgSO(4) was given intravenously over 1 to 2 minutes followed by continuous infusion for the next 2 to 7 days.
Of the six patients, five responded completely to the initial bolus of 6.1 +/- 4.2 mg/kg (range, 2.3-12 mg/kg). One (a neonate with congenital LQTS) required a total of 30 mg/kg until complete TdP elimination. Continuous infusion was given at rates of 0.3 to 1.0 mg/kg/hr with no recurrence of TdP. SMg concentration was 3.9 +/- 1.0 mg/dL (2.9-5.4 mg/dL) immediately after bolus injection.
Intravenous MgSO(4) infusion effectively treated TdP in children with LQTS. Optimal bolus dosage, infusion rates and SMg concentration were 3 to 12 mg/kg, 0.5 to 1.0 mg/kg/hr and 3 to 5 mg/dL, respectively.
静脉注射硫酸镁（MgSO₄）是治疗成人获得性长QT综合征（LQTS）相关尖端扭转型室速（TdP）的一种非常有效且安全的方法。本文讨论了MgSO₄对先天性和获得性LQTS患儿TdP的疗效。
对6例连续的TdP患儿确定了最佳MgSO₄剂量和血清镁（SMg）水平；其中4例患有先天性LQTS，2例患有获得性LQTS。静脉推注MgSO₄ 1至2分钟，随后在接下来的2至7天持续输注。
6例患者中，5例对初始6.1±4.2mg/kg（范围2.3 - 12mg/kg）的推注完全有反应。1例（1名先天性LQTS新生儿）总共需要30mg/kg直至TdP完全消除。以0.3至1.0mg/kg/小时的速率持续输注，TdP未复发。推注后即刻SMg浓度为3.9±1.0mg/dL（2.9 - 5.4mg/dL）。
静脉输注MgSO₄有效治疗了LQTS患儿的TdP。最佳推注剂量、输注速率和SMg浓度分别为3至12mg/kg、0.5至1.0mg/kg/小时和3至5mg/dL。
