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MAGNESIUM DISCUSSION PRO AND CON

MAGNESIUM DISCUSSION PRO AND CON. MAGNESIUM SHOULD BE ADMINISTERED TO ALL CORONARY ARTERY BYPASS GRAFT SURGERY PATIENTS UNDERGOING CARDIOPULMONARY BYPASS ?. Eugene Yevstratov MD. Mg + as an element. Cofactor for more than 260 enzymes Required for oxidative metabolism

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MAGNESIUM DISCUSSION PRO AND CON

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  1. MAGNESIUM DISCUSSION PRO AND CON MAGNESIUM SHOULD BE ADMINISTERED TOALLCORONARY ARTERY BYPASS GRAFT SURGERY PATIENTS UNDERGOING CARDIOPULMONARY BYPASS ? Eugene Yevstratov MD

  2. Mg+ as an element • Cofactor for more than 260 enzymes • Required for oxidative metabolism • Required for protein syntesis • Required for maintenace of ion cell balance • A normal function of ion pumps

  3. Mg + administration (pro) • Eliminate the deleteriouse effects of hypomagnesemia (a common, often unrecognized condition in cardiac surgical patients) • Decrease myocardial insult induced during aortic crossclamp • Decrease the incidence of postoperative arrhythmias

  4. Some effects of myocardial ischemia and reperfusion • Increased intracellular calcium • Production of oxygen – derived free radicals • Depletion of high energy phosphates

  5. Mg+ action site • Magnesium is an inorganic calcium channel blocker • Magnesium blocks reperfusion indused free radical formation • Magnesium reduce the myocardial insult during an ischemia reperfusion sequence • Magnesium as a cellular cofactor help unto myocardial cell to reestablish oxidative metabolism and replenish high energy phosphate stores • Magnesium ATP complex is olso the substrate for enzymatic reactions underlying muscule contraction and relaxation.

  6. Antiarrhythmic value • Is important in maintaining the ionic balance across the cell membrane • During ischemia prevents the detrimental intracellular potassium efflux and calcium efflux • A key ion in maintaining the cellular ionic gradients • Accepted as a treatment for ventricular tachycardia, torsade de points, supraventricular arrhythmias, including atrial fibrilation

  7. Magnesium • Readily available • Easily administered • Inexpensive

  8. Magnesium+ (con) • Muscle paralysis compromising respiratory function or delaying extubation • Sedation and confusion • Hypotension • Increased posoperative bleeding as result of inhibition of platlet function • Increased energy requirement for defibrilation after intraoperative magnesium supplementation

  9. The End November 2002 http://myprofile.cos.com/eugenefox

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