Mohammadzadeh Alireza, Towfighi Farshad, Jafari Naser
Department of Cardiothoracic, Imam Khomeini Hospital, Ardabil University of Medical Sciences, Ardabil, Iran.
ANZ J Surg. 2018 Jun;88(6):612-615. doi: 10.1111/ans.14056. Epub 2017 May 22.
Cardiac arrhythmia after coronary artery bypass grafting (CABG) surgery is a common complication of cardiac surgery. The effect of serum magnesium, hypomagnesaemia treatment and prophylactic administration of magnesium in the development and prevention of arrhythmias is controversial and there are many different ideas. This study evaluates the therapeutic effects of magnesium in cardiac arrhythmia after CABG surgery.
The clinical trial enrolled 250 patients who underwent CABG. Based on the initial serum levels of magnesium, patients were divided into two groups: hypomagnesium and normomagnesium. Based on bioethics committee requirements, patients in the hypo-magnesium group received magnesium treatments until they attained normal magnesium blood levels. Both groups underwent CABG with normal blood levels of magnesium. After surgery, each group was randomly divided into two subgroups: one subgroup received a bolus dose of magnesium sulphate (30 mg/kg in 5 min) and the other subgroup received a placebo. Subgroups were under observation in the intensive care unit for 3 days and arrhythmias were recorded. Data from all four subgroups were analysed statistically and interpreted.
The results of this study showed that the occurrence of arrhythmia was not significantly different among subgroups (P > 0.05). There was no significant relationship between blood levels of magnesium and arrhythmia during the 3 days post-surgery (P > 0.05).
The results of this study showed that magnesium sulphate administration did not significantly improve the incidence of arrhythmias in hypo- and normo-magnesium patients after CABG. There was no significant correlation between post-operative serum levels of magnesium and arrhythmia during 3 days.
冠状动脉旁路移植术(CABG)后心律失常是心脏手术常见的并发症。血清镁、低镁血症治疗及预防性应用镁在心律失常发生和预防中的作用存在争议,且观点各异。本研究评估镁对CABG术后心律失常的治疗效果。
该临床试验纳入250例行CABG的患者。根据初始血清镁水平,将患者分为两组:低镁组和正常镁组。根据生物伦理委员会要求,低镁组患者接受镁治疗直至血镁水平恢复正常。两组均在血镁水平正常的情况下进行CABG。术后,每组随机分为两个亚组:一个亚组静脉推注硫酸镁(5分钟内30mg/kg),另一个亚组接受安慰剂。亚组在重症监护病房观察3天,并记录心律失常情况。对所有四个亚组的数据进行统计分析和解读。
本研究结果显示,各亚组心律失常发生率无显著差异(P>0.05)。术后3天内血镁水平与心律失常之间无显著相关性(P>0.05)。
本研究结果表明,硫酸镁给药并未显著改善CABG术后低镁和正常镁患者的心律失常发生率。术后3天内血清镁水平与心律失常之间无显著相关性。