Key result
IV magnesium bolus after cardiopulmonary bypass cuts atrial fibrillation by ~64% versus control.
Why the study?
The effect of intravenous magnesium sulfate given prophylactically while coming off cardiopulmonary bypass on post-operative rhythm disturbances in cardiac surgery patients was evaluated.
Does prophylactic intravenous magnesium sulfate reduce the incidence of atrial fibrillation in patients undergoing on-pump cardiac surgery?
RCT (n=260)
Double-blind
randomized
No
Does prophylactic intravenous magnesium sulfate reduce the incidence of atrial fibrillation in patients undergoing on-pump cardiac surgery?
Absolute Event Rate: 7.7% vs 21.6%
p-value: p=0.032
A single 1 gm IV bolus of magnesium sulfate administered during weaning from cardiopulmonary bypass significantly reduces the incidence of post-operative atrial fibrillation and the need for pharmacological support.
May reduce AF after on-pump cardiac surgery; leaves open whether routine use should be adopted pending larger trials.
To evaluate the effect of intravenous magnesium sulfate on post-operative complications when given prophylactically while coming of cardio pulmonary bypass (CPB) in patients undergoing cardiac surgery.A double-blinded randomized study conducted at a tertiary care center in western Maharashtra from Nov 2017 to April 2019.Patients were divided into two groups.Group A (Magnesium sulfate group) (n=130) & Group B (control group) (n=130).Patients undergoing on pump Coronary artery bypass grafting (CABG), Mitral valve replacement/repair (MVR), Aortic Valve Replacement (AVR) or both AVR & MVR (DVR) on CPB were included in the study.Once surgery was over, aortic cross clamp taken out & temperature of 36°c was attained, Group A patients received Injection Magnesium sulfate 1 gm IV slowly over 10 minutes.Patients were monitored for heart rate, intra-arterial blood pressure oxygen saturation, continuous electrocardiograph with automatic ST segment analysis apart from this ECG mapping was done.There was no significant Statistical difference regarding the demographic data, comorbidities & ejection fraction between the two groups.The result shows a statistically significant difference (P=0.032) between the two groups with regards to the incidence of atrial fibrillation.In group A 10 patients (7.70%) had atrial fibrillation compared to group B where 28 patients (21.6%) had atrial fibrillation.Weaning from CPB was easier in group A patient compared to group B & also group A patient needed smaller doses of pharmacological support, than group B. A single bolus 1Gm dose of magnesium sulfate while coming off from CPB has an excellent effect in reducing the incidence of atrial fibrillation.Further magnesium reduced the amount of pharmacological support which was required to come off CPB.
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Mishra et al. (2019) conducted an RCT in Cardiac surgery (n=260). Magnesium sulfate vs. Control was evaluated on Incidence of atrial fibrillation (p=0.032). A single 1 gm IV bolus of magnesium sulfate administered while coming off cardiopulmonary bypass reduced the incidence of atrial fibrillation compared to control (7.7% vs 21.6%; P=0.032).
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