The advantages of measuring the serum ionized magnesium level when performing cardiac surgery

• Published in: Journal of the Japanese Society of Intensive Care Medicine Vol. 29; no. 2; pp. 117 - 122
• Main Authors: Kometani, Satoshi, Shimomura, Rika, Kawai, Michihiko, Takei, Tomohide, Kuwabara, Daisuke, Kawakami, Tadashi, Ikezaki, Hiroyuki
• Format: Journal Article
• Language: Japanese; English
• Published: The Japanese Society of Intensive Care Medicine 01.03.2022
• Subjects: cardiac surgery; cardioplegia; cardiopulmonary bypass; hypermagnesemia; ionized magnesium
• ISSN: 1340-7988; 1882-966X
• DOI: 10.3918/jsicm.29_117

Background: The present study evaluated the advantages of measuring the serum ionized magnesium (iMg) level when performing cardiac surgery. Methods: In this prospective cohort study of 35 consecutive patients who underwent elective cardiac surgery from December 2018 to May 2019, the patients were divided into two groups, namely Group P (n=25, with cardiopulmonary bypass [CPB]) and Group C (n=10, without CPB). The perioperative changes in the iMg values were compared between the groups and any correlations between the iMg and total magnesium (tMg) levels were analyzed. Results: A significant increase in the iMg level was seen in group P after cardioplegia administration (1.04 [0.54- 1.26] mmol/L), it remained elevated even in the ICU after surgery (0.86 [0.75〜1.00] mmol/L). In addition, the correlation coefficient between the iMg and tMg level was 0.404 in group P at the end of surgery. Conclusions: During cardiac surgery, we should be aware of hypermagnesamia as a potential consequence of cardioplegia administration. Therefore, monitoring the serum magnesium level using iMg is beneficial to avoid the overadministration of magnesium during perioperative management.