Pro: Magnesium should be administered to all coronary artery bypass graft surgery patients undergoing cardiopulmonary bypass

MAGNESIUM, the second most abundant intracellular cation, is central to the viability of all cells. Intracellular magnesium is a required cofactor for more than 260 enzymes, including nearly all adenosine triphosphatases (ATPases), phosphatases, and kinases. 1 Lareau S Boyle AJ Stewart LC et al. The role of magnesium in myocardial preservation. Magnes Res. 1995; 8: 85-97 PubMed Google Scholar , 2 Birch RFH Lake CL Pro: Magnesium is a valuable therapy in the cardiac surgical patient. J Cardiothorac Vasc Anesth. 1991; 5: 518-521 Abstract Full Text PDF PubMed Scopus (13) Google Scholar , 3 Aziz S Haigh G Van Norman GA et al. Blood ionized magnesium concentrations during cardiopulmonary bypass and their correlation with other circulating cations. J Card Surg. 1996; 11: 341-347 Crossref PubMed Scopus (18) Google Scholar Its presence is required for oxidative metabolism. Magnesium offers significant potential benefits when administered to patients undergoing cardiopulmonary bypass (CPB). Magnesium administration to this group may (1) eliminate the deleterious effects of hypomagnesemia, a common, often unrecognized condition in cardiac surgical patients; (2) decrease the myocardial insult induced during aortic cross-clamp; and (3) decrease the incidence of postoperative arrhythmias. If a therapeutic intervention shows benefits that outweigh any associated risks and economic costs, 4 Antman EM Magnesium in acute myocardial infarction: Overview of available evidence. Am Heart J. 1996; 132: 487-502 Abstract Full Text PDF PubMed Scopus (42) Google Scholar that intervention should be used. Magnesium, inexpensive, readily available, and easily administered, is such an intervention.