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Ann Thorac Surg 1997;64:572-577
© 1997 The Society of Thoracic Surgeons

Current Review

Magnesium Deficiency and Cardiogenic Shock After Cardiopulmonary Bypass

Waldemar Storm, MD, Jerry J. Zimmerman, MD, PhD

Pediatric Intensive Care, MeritCare Children's Hospital, Fargo, North Dakota, and Pediatric Critical Care Fellowship and Research Programs, University of Wisconsin-Madison Medical School, Madison, Wisconsin

Magnesium is an important cation that has a key role in cellular processes of energy transfer and utilization involving adenosine triphosphate, and influences cell membrane functions. Its antiarrhythmic properties are well-known and it is widely recognized as an adjunct for the treatment of arrhythmias after myocardial infarction and cardiopulmonary bypass. Magnesium may influence hemodynamic performance through its effects on vascular tone, modulation of intracellular calcium, regulation of catecholamine activity, and its essential role in adenosine triphosphate metabolism. The potential for magnesium deficiency to affect cardiovascular performance may be especially relevant in ischemic states. We report a case of cardiogenic shock developing after cardiopulmonary bypass that was initially unresponsive to therapeutic intervention, but that resolved promptly after magnesium administration. The potential role of magnesium in enhancing hemodynamic performance is discussed, with a review of its cellular metabolic properties and activities.




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Whole blood ionized magnesium: age-related differences in normal values and clinical implications of ionized hypomagnesemia in patients undergoing surgery for congenital cardiac disease
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[Abstract] [Full Text] [PDF]


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