Department of Anesthesia and Critical Care, Hôtel-Dieu de France hospital, Université Saint-Joseph, Beirut, Lebanon.
Department of Cardiovascular and Thoracic Surgery, Hôtel-Dieu de France hospital, Université Saint-Joseph, Beirut, Lebanon.
Eur J Cardiothorac Surg. 2022 Oct 4;62(5). doi: 10.1093/ejcts/ezac269.
Postoperative atrial fibrillation (POAF) is common following coronary artery bypass grafting (CABG) surgery. Hypomagnesemia is frequent after CABG surgery. No previous trials have assessed the effect of preoperative magnesium (Mg) loading on POAF incidence.
This was a single-centre, double-blind, placebo-controlled, parallel-group trial, with balanced randomization [1:1]. The participants were recruited from November 2018 until May 2019. Patients received either 3.2 g of Mg daily (4 tablets of 0.4 g each twice daily) for 72 h preoperatively and 1.6 g of Mg (4 tablets) on the day of surgery or placebo tablets.
The primary outcome was the incidence of POAF. Secondary outcomes included time to extubation, transfusion rate, critical care unit and hospital length of stay. Of the 210 randomized participants, 200 (100 in each group) completed the study. A total of 10 (10%) and 22 (22%) subjects developed POAF in the Mg and placebo groups, respectively (RR = 0.45, 95% confidence interval: 0.23-0.91). Hospital and critical care unit length of stay were comparable between the 2 groups. No side effects related to Mg administration were documented.
In this randomized controlled trial, preoperative loading with oral administration of Mg for 3 days in patients admitted for CABG surgery decreases the incidence of POAF compared to placebo.
NCT03703349.
冠状动脉旁路移植术（CABG）后常发生术后心房颤动（POAF）。CABG 手术后常发生低镁血症。以前没有试验评估术前镁（Mg）负荷对 POAF 发生率的影响。
这是一项单中心、双盲、安慰剂对照、平行组试验，采用平衡随机化[1:1]。参与者于 2018 年 11 月至 2019 年 5 月招募。患者接受术前 72 小时每天 3.2g Mg（4 片 0.4g 每日 2 次）和手术当天 1.6g Mg（4 片）或安慰剂片。
主要结局是 POAF 的发生率。次要结局包括拔管时间、输血率、重症监护病房和医院住院时间。在 210 名随机参与者中，有 200 名（每组 100 名）完成了研究。Mg 组和安慰剂组分别有 10 名（10%）和 22 名（22%）患者发生 POAF（RR=0.45，95%置信区间：0.23-0.91）。两组的住院时间和重症监护病房住院时间相当。未记录到与 Mg 给药相关的副作用。
在这项随机对照试验中，与安慰剂相比，在 CABG 手术入院患者中连续 3 天口服 Mg 负荷可降低 POAF 的发生率。
NCT03703349。
