Key result
The use of Plegisol during cardiopulmonary bypass in pediatric patients led to higher ionized magnesium levels and a non-significant increase in the probability of dysrhythmias (P=0.22).
Why the study?
Does a magnesium-containing cardioplegic solution alter ionized magnesium concentrations and dysrhythmia incidence in neonates, infants, and children undergoing repair of congenital heart lesions?
Observational (n=115)
Does a magnesium-containing cardioplegic solution alter ionized magnesium concentrations and dysrhythmia incidence in neonates, infants, and children undergoing repair of congenital heart lesions?
p-value: p=0.22
The use of magnesium-containing cardioplegia during pediatric cardiopulmonary bypass significantly alters ionized magnesium levels, though its impact on dysrhythmias remains unclear.
iMg changes during pediatric CPB vary by weight and cardioplegia; leaves open any dysrhythmia link for prospective evaluation.
The purpose of this study was to measure the ionized magnesium (iMg) concentrations in children undergoing the correction of congenital heart defects. iMg levels were measured in 115 consecutive patients at five sample periods: prebypass, onset of bypass, during rewarming, immediately postbypass, and 1 h postbypass using an ion-selective electrode of the NOVA-CRT 8 (Nova Biomedical, Watham, MA). The incidence of dysrythmias was noted. Patients were divided into two groups: those who received Plegisol as the cardioplegic solution and those who did not. This study demonstrates that iMg decreases with the onset of cardiopulmonary bypass (CPB) in patients who weigh < 10 kg. In the Plegisol group, all subgroups of patients demonstrated statistically higher iMg during the rewarming phase of CPB, immediately post-CPB, and 1 h post-CPB, when compared with control values. The probability of dysrhythmias in the Plegisol group was almost twice that of the non-Plegisol group. However, this did not reach statistical significance (P = 0.22). The results of our study demonstrate that the use of CPB on pediatric patients produces alterations in the iMg. The changes differ depending on both patient weight and the use of a magnesium-containing cardioplegic solution, exemplified here by Plegisol. The role of these changes in iMg on dysrhythmias could not be further evaluated.
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Fox et al. (1997) conducted an observational in Congenital heart defects (n=115). Plegisol (magnesium-containing cardioplegic solution) vs. Non-Plegisol cardioplegic solution was evaluated on Incidence of dysrhythmias (p=0.22). The use of Plegisol during cardiopulmonary bypass in pediatric patients led to higher ionized magnesium levels and a non-significant increase in the probability of dysrhythmias (P=0.22).
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