Detection of arrhythmogenic cellular magnesium depletion in hip surgery patients

G. Zuccalà, M. Pahor, F. Lattanzio, S. Vagnoni, F. Rodolà, P. De Sole, A. Cittadini, A. Cocchi, R. Bernabei

Research output: Contribution to journalArticle

Abstract

The use of high-dose magnesium infusions in critically ill and surgical patients is increasing. This practice is associated with considerable risk of toxicity, as no reliable criteria are currently available to detect significant intracellular magnesium depletion. We have evaluated, before and after surgery, 33 elderly patients with hip fracture, by 24-h Holter ECG monitoring, Doppler echocardiography and serum chemistry; lymphocyte magnesium was measured using atomic absorption spectrophotometry. The severity of ventricular arrhythmias increased, and serum and mononuclear magnesium concentrations decreased significantly after surgery. Decreases in either serum magnesium concentrations > 0.125 mmol litre-1 or cellular magnesium > 6 nmol mg-1, but not serum or lymphocyte absolute magnesium concentrations, were associated with postoperative development of repetitive arrhythmias. Variations in serum magnesium concentrations correlated with intracellular decreases, and yielded good accuracy in predicting the postoperative worsening of arrhythmias. Thus perioperative differences in serum magnesium concentrations reflected intracellular variations and allowed us to identify patients with clinically relevant cellular magnesium depletion.

Original languageEnglish
Pages (from-to)776-781
Number of pages6
JournalBritish Journal of Anaesthesia
Volume79
Issue number6
Publication statusPublished - Dec 1997

Keywords

  • Complications, magnesium depletion
  • Heart, arrhythmia
  • Ions, magnesium
  • Measurement techniques, spectrophotometry
  • Surgery, orthopaedic

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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    Zuccalà, G., Pahor, M., Lattanzio, F., Vagnoni, S., Rodolà, F., De Sole, P., Cittadini, A., Cocchi, A., & Bernabei, R. (1997). Detection of arrhythmogenic cellular magnesium depletion in hip surgery patients. British Journal of Anaesthesia, 79(6), 776-781.