The Influence of Cardiopulmonary Bypass on Ionized Magnesium in Neonates, Infants, and Children Undergoing Repair of Congenital Heart Lesions

• Published in: Anesthesia and analgesia Vol. 84; no. 3; pp. 497 - 500
• Main Authors: Fox, M. L., Burrows, F. A., Reid, R. W., Hickey, P. R., Laussen, P. C., Hansen, D. D.
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD International Anesthesia Research Society 01.03.1997; Lippincott
• Subjects: Adolescent; Adult; Arrhythmias, Cardiac - blood; Bicarbonates - therapeutic use; Biological and medical sciences; Calcium Chloride - therapeutic use; Cardioplegic Solutions - therapeutic use; Cardiopulmonary Bypass; Child; Child, Preschool; Heart Defects, Congenital - surgery; Humans; Infant; Infant, Newborn; Magnesium - blood; Magnesium - therapeutic use; Medical sciences; Potassium Chloride - therapeutic use; Sodium Chloride - therapeutic use; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Time Factors; Human; Magnesemia; Congenital; Arrhythmia; Cardiovascular disease; Congenital disease; Cardiopulmonary bypass; Newborn; Heart disease; Surgery; Risk factor; Complication; Magnesium; Child
• ISSN: 0003-2999; 1526-7598
• DOI: 10.1097/00000539-199703000-00005

The purpose of this study was to measure the ionized magnesium (iMg) concentrations in children undergoing the correction of congenital heart defects.iMg levels were measured in 115 consecutive patients at five sample periodsprebypass, onset of bypass, during rewarming, immediately postbypass, and 1 h postbypass using an ion-selective electrode of the NOVA-CRT 8[TM] (Nova Biomedical, Watham, MA). The incidence of dysrythmias was noted. Patients were divided into two groupsthose who received Plegisol[R] as the cardioplegic solution and those who did not. This study demonstrates that iMg decreases with the onset of cardiopulmonary bypass (CPB) in patients who weigh <10 kg. In the Plegisol[R] group, all subgroups of patients demonstrated statistically higher iMg during the rewarming phase of CPB, immediately post-CPB, and 1 h post-CPB, when compared with control values. The probability of dysrhythmias in the Plegisol[R] group was almost twice that of the non-Plegisol[R] group. However, this did not reach statistical significance (P = 0.22). The results of our study demonstrate that the use of CPB on pediatric patients produces alterations in the iMg. The changes differ depending on both patient weight and the use of a magnesium-containing cardioplegic solution, exemplified here by Plegisol[R]. The role of these changes in iMg on dysrhythmias could not be further evaluated.(Anesth Analg 1997;84:497-500)