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Magnesium and Cardiac Surgery in the Critical Care Setting

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Diet and Nutrition in Critical Care

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Abstract

Magnesium (Mg) is an important intracellular ion with electrophysiological properties. It is essential for optimal metabolic cell function. Serum Mg is a poor predictor of body stores, as less than 1 % of total body Mg is found in serum. Ionized Mg assessment, the active portion of Mg, may be a more useful indicator than total serum Mg assessment.

Hypomagnesemia is common in the cardiac surgical population and correlates with higher incidence of cardiac arrhythmias and major adverse cardiac events. However, the role of Mg in preventing postoperative arrhythmias – especially atrial fibrillation – is controversial. There is moderate evidence that intravenous Mg therapy, particularly low doses administered before cardiac surgery, will reduce the postoperative incidence of atrial fibrillation.

Hypomagnesemia is also common in hospitalized patients. It is especially prevalent in the critically ill and correlates with worse clinical outcomes. Mg has proven effective for treating eclampsia, preeclampsia, and torsades de pointes. Other therapeutic applications such as adjunctive therapy in acute asthma exacerbations, acute coronary syndromes, acute cerebral ischemia, and postoperative pain control are under discussion. Mg has a low adverse effects profile and multiple theoretical advantages, including its low cost.

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Abbreviations

AF:

Atrial fibrillation

AMI:

Acute Myocardial infarction

ATP:

Adenosine triphosphate

CABG:

Coronary artery bypass graft

ICU:

Intensive care unit

Mg:

Magnesium

MgSO4:

Magnesium sulfate

SAH:

Subarachnoid hemorrhage

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Authors and Affiliations

  1. Department of Intensive Care, Hospital Universitari de Bellvitge, IDIBELL (Institut d’Investigació Biomèdica Bellvitge; Biomedical Investigation Institute of Bellvitge), Universitat de Barcelona, C/Feixa Llarga s/n. 08907, L’Hospitalet de Llobregat, Barcelona, Spain

    Maria L. Carrio, Juan Carlos Lopez-Delgado, Herminia Torrado, Elisabet Farrero, David Rodríguez-Castro & Josep L. Ventura

  2. Department of Physiological Sciences II, IDIBELL (Institut d’Investigació Biomèdica Bellvitge; Biomedical Investigation Institute of Bellvitge), Universitat de Barcelona, C/Feixa Llarga s/n. 08907, L’Hospitalet de Llobregat, Barcelona, Spain

    Casimiro Javierre

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  1. Maria L. Carrio
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  2. Juan Carlos Lopez-Delgado
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  3. Casimiro Javierre
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  4. Herminia Torrado
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  5. Elisabet Farrero
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  6. David Rodríguez-Castro
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  7. Josep L. Ventura
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Correspondence to Maria L. Carrio .

Editor information

Editors and Affiliations

  1. Royal Free London Hospitals, Barnet General Hospital, London, UK

    Rajkumar Rajendram

  2. Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK

    Rajkumar Rajendram

  3. King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia

    Rajkumar Rajendram

  4. Department of Nutrition and Dietetics, Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, UK

    Victor R. Preedy

  5. Department of Biomedical Sciences, Faculty of Science & Technology, University of Westminster, London, UK

    Vinood B. Patel

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Carrio, M.L. et al. (2015). Magnesium and Cardiac Surgery in the Critical Care Setting. In: Rajendram, R., Preedy, V.R., Patel, V.B. (eds) Diet and Nutrition in Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7836-2_138

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