Institute for Biomedical Research, Heart Center, Kaunas University of Medicine, Lithuania.
Medicina (Kaunas). 2009;45(12):960-70.
Our study was designed to assess the incidence of atrial fibrillation, changes in serum electrolyte concentrations and urinary electrolyte excretion following coronary artery bypass grafting surgery.
A total of 165 patients who underwent elective coronary artery bypass grafting surgery at the Department of Cardiac Surgery (Heart Center) during the period of 2004-2005 were enrolled. Serum K(+), Na(+), Mg(2+), Ca(2+), Cl(-), and P(-) concentrations were measured before cardiopulmonary bypass (CPB), on the arrival to an intensive care unit, and 15-18 hours after the surgery. Urinary excretion of K(+), Na(+), Mg(2+), Ca(2+), Cl(-), and P(-) was estimated 24 hours before the surgery, during the surgery, and 24 hours after the surgery. Cardiac rhythm was monitored throughout the study. All patients randomly were divided into the group 1 (n=55), which received magnesium sulphate infusion, and group 2 (n=110), which did not receive magnesium sulphate.
The overall incidence of atrial fibrillation was 27.4%. The patients in the group 1 had significantly higher levels of serum magnesium before CPB and serum chloride after the surgery. Urinary magnesium and calcium excretion was significantly higher in the group 1 during and after the surgery. Before the surgery and 24 hours after the surgery, phosphate excretion was significantly higher in the group 1.
The incidence of atrial fibrillation after myocardial revascularization surgery remains high (27.4%). Serum electrolyte concentrations after myocardial revascularization varied within normal ranges. Magnesium sulphate infusion did not decrease the rate of postoperative atrial fibrillation during the early postoperative period in normomagnesemic patients.
本研究旨在评估冠状动脉旁路移植术后心房颤动的发生率、血清电解质浓度变化和尿电解质排泄情况。
选取 2004 年至 2005 年在心脏外科（心脏中心）行择期冠状动脉旁路移植术的 165 例患者。在体外循环（CPB）前、到达重症监护病房时以及术后 15-18 小时，测定血清 K(+)、Na(+)、Mg(2+)、Ca(2+)、Cl(-)和 P(-)浓度。在术前 24 小时、手术中和术后 24 小时，估计尿 K(+)、Na(+)、Mg(2+)、Ca(2+)、Cl(-)和 P(-)的排泄量。在整个研究过程中监测心律。所有患者随机分为 1 组（n=55）和 2 组（n=110），1 组接受硫酸镁输注，2 组未接受硫酸镁输注。
心房颤动总发生率为 27.4%。CPB 前 1 组血清镁水平明显升高，术后血清氯水平明显升高。1 组在手术中和手术后的尿镁和尿钙排泄明显升高。手术前和手术后 24 小时，1 组的磷酸盐排泄明显升高。
心肌血运重建术后心房颤动的发生率仍然较高（27.4%）。心肌血运重建术后血清电解质浓度在正常范围内波动。在镁正常的患者中，硫酸镁输注并不能降低术后早期心房颤动的发生率。
