Magnesium and Its Role in Cardiac Surgical Practice: A Review
Journal of Clinical and Basic Cardiology 2002; 5 (1): 67-73
Keywords: Herzchirurgie, Kardioplegie, magnesium, Physiologie, plasma, cardiac surgery, cardioplegia, magnesium, physiology, plasma
Magnesium is a coenzyme essential to numerous cellular processes and it modulates the electrical conduction of the heart and its contractility. Magnesium deficiency though often caused by cardiac surgery may not be readily diagnosed. Its metabolism may be deranged by effect of cardiopulmonary bypass, by increased excretion and by the secondary effects of the neuroendocrine response to surgery. These changes induce both cardiac symptoms evident as arrhythmias and reduced cardiac function, and neurological disturbances. Active management of magnesium metabolism can ameliorate many of the shifts in electrolyte balance and the resultant problems. In addition, magnesium may be administered as a pharmacological agent to inhibit the myocardial injury that arises during periods of ischaemia. It is the aim of this article to present the contemporary state of knowledge on this subject and to clarify some of its complexities that arise from apparently conflicting details. It is also intended to present the case for a more aggressive approach to be taken to the management of magnesium metabolism than is commonly adopted.