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Frontiers in Neurology 2023The use of magnesium sulfate for treating aneurysmal subarachnoid hemorrhage (aSAH) has shown inconsistent results across studies. To assess the impact of magnesium...
INTRODUCTION
The use of magnesium sulfate for treating aneurysmal subarachnoid hemorrhage (aSAH) has shown inconsistent results across studies. To assess the impact of magnesium sulfate on outcomes after aSAH, we conducted a systematic review and meta-analysis of relevant randomized controlled trials.
METHODS
PubMed, Embase, and the Cochrane Library were searched for relevant literature on magnesium sulfate for aSAH from database inception to March 20, 2023. The primary outcome was cerebral vasospasm (CV), and secondary outcomes included delayed cerebral ischemia (DCI), secondary cerebral infarction, rebleeding, neurological dysfunction, and mortality.
RESULTS
Of the 558 identified studies, 16 comprising 3,503 patients were eligible and included in the analysis. Compared with control groups (saline or standard treatment), significant differences were reported in outcomes of CV [odds ratio (OR) = 0.61, = 0.04, 95% confidence interval (CI) (0.37-0.99)], DCI [OR = 0.57, = 0.01, 95% CI (0.37-0.88)], secondary cerebral infarction [OR = 0.49, = 0.01, 95% CI (0.27-0.87)] and neurological dysfunction [OR = 0.55, = 0.04, 95% CI (0.32-0.96)] after magnesium sulfate administration, with no significant differences detected in mortality [OR = 0.92, = 0.47, 95% CI (0.73-1.15)] and rebleeding [OR = 0.68, = 0.55, 95% CI (0.19-2.40)] between the two groups.
CONCLUSION
The superiority of magnesium sulfate over standard treatments for CV, DCI, secondary cerebral infarction, and neurological dysfunction in patients with aSAH was demonstrated. Further randomized trials are warranted to validate these findings with increased sample sizes.
PubMed: 38020616
DOI: 10.3389/fneur.2023.1249369 -
BMC Geriatrics Jul 2023Propofol-based sedations are widely used in elderly patients for endoscopic retrograde cholangiopancreatography (ERCP) procedure, but respiratory depression and... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Propofol-based sedations are widely used in elderly patients for endoscopic retrograde cholangiopancreatography (ERCP) procedure, but respiratory depression and cardiovascular adverse events commonly occur. Magnesium administered intravenously can alleviate pain and decrease propofol requirements during surgery. We hypothesized that intravenous magnesium was used as adjuvant to propofol might be beneficial in elderly patients undergoing ERCP procedures.
METHODS
Eighty patients aged from 65 to 79 years who were scheduled for ERCP were enrolled. All patients were intravenously administered 0.1 µg/kg sufentanil as premedication. The patients were randomized to receive either intravenous magnesium sulfate 40 mg/kg (group M, n = 40) or the same volume of normal saline (group N, n = 40) over 15 min before the start of sedation. Intraoperative sedation was provided by propofol. Total propofol requirement during ERCP was the primary outcome.
RESULTS
The total propofol consumption were reduced by 21.4% in the group M compared with the group N (151.2 ± 53.3 mg vs. 192.3 ± 72.1 mg, P = 0.001). The incidences of respiratory depression episodes and involuntary movement were less in the group M than those in the group N (0/40 vs. 6/40, P = 0.011; 4/40 vs. 11/40, P = 0.045; respectively). In the group M, the patients experienced less pain than those in the group N at 30 min after the procedure (1 [0-1] vs. 2 [1-2], P < 0.001). Correspondingly, the patients' satisfaction was clearly higher in the group M (P = 0.005). There was a tendency towards lower intraoperative heart rate and mean arterial pressure in group M.
CONCLUSIONS
A single bolus of 40 mg/kg of intravenous magnesium can significantly reduce propofol consumption during ERCP, with higher sedation success and lower adverse events.
TRIAL REGISTRATION
ID UMIN000044737. Registered 02/07/2021.
Topics: Humans; Aged; Propofol; Hypnotics and Sedatives; Cholangiopancreatography, Endoscopic Retrograde; Magnesium Sulfate; Magnesium; Pain; Double-Blind Method; Administration, Intravenous; Respiratory Insufficiency
PubMed: 37420201
DOI: 10.1186/s12877-023-04107-6 -
Plants (Basel, Switzerland) Nov 2023Soil salinity is a well-known abiotic factor affecting the germination and seedling growth of various plant species. Therefore, we evaluated the effects of different...
Soil salinity is a well-known abiotic factor affecting the germination and seedling growth of various plant species. Therefore, we evaluated the effects of different chloride salts (NaCl, KCl and MgCl) and sulfate salts (NaSO, KSO and MgSO) on the seed germination and early seedling growth of two important ethnomedicinal shrubs of North Africa and the Mediterranean basin ( and ). Seeds of these species were subjected to five salinity levels (0-100 mM) and incubated at 20 °C under a light regime (12 h photoperiod). Both species demonstrated their highest germination percentage under control conditions (i.e., without salinity). However, as salinity levels increased, the germination percentages for both species decreased, regardless of the type of salt used. Cations appeared to be more determinative than the anions in regulating the seed germination of both species. seeds displayed greater sensitivity to sodium (Na) salts, especially when accompanied with chloride (Cl) anions. At the higher salt concentrations (75 and 100 mM), Na salts had a more pronounced inhibitory effect on seedling growth compared to potassium (K) and magnesium (Mg) salts. Conversely, Mg salts were more detrimental to seedling growth in . Based on our results, it can be concluded that both of these species are able to tolerate a moderate level of salinity. Overall, may be a promising choice for rehabilitating the soils dominated by chloride salts, while could be utilized for restoring sulfate-dominated soils.
PubMed: 38005803
DOI: 10.3390/plants12223906 -
Cureus Nov 2023Intraventricular hemorrhage (IVH) is a type of bleeding that occurs through the germinal matrix and comes through the ependymal cells into the ventricular cavity. It is... (Review)
Review
Intraventricular hemorrhage (IVH) is a type of bleeding that occurs through the germinal matrix and comes through the ependymal cells into the ventricular cavity. It is mostly seen in preterm neonates but can also be seen sometimes in term neonates. Various factors predispose to preterm delivery; it can be spontaneous or medically induced. Spontaneous IVH occurs in cases of intrauterine infections in the mother, and it can be induced in cases of medical emergencies such as preeclampsia and eclampsia. The brain of a preterm newborn is not fully developed as it does not have pericytes and proteins, so it can bleed very quickly, which can cause IVH. Also, the vessels supplying the germinal matrix are immature and highly vascularized. IVH has four grades based on findings detected on cranial ultrasound and MRI. Management includes medical and surgical management; medical management includes phenobarbitone used for seizures and prophylaxis. Surgical management includes drainage, irrigation, and fibrinolytic therapy (DRIFT), and neuro-endoscopic lavage. IVH causes various short-term and long-term neurodevelopmental consequences. Long-term complications include cerebral palsy and intellectual disability, which hamper the life of the child. It mainly presents with seizures, flaccidity, decerebrate posture, etc. Various preventive measures can be taken to tackle IVH in newborns. First of all, preterm delivery should be avoided, and intrauterine infections in mothers should be treated. The administration of corticosteroids should be done for all preterm deliveries as it helps in the maturation of organs. The administration of magnesium sulfate should be done as it is neuroprotective and reduces cerebral palsy in the future. Delayed cord clamping is to be done to reduce recurrent blood transfusions and decrease the risk of IVH. This article explains the pathogenesis, management, prevention, and future outcomes of IVH.
PubMed: 38111458
DOI: 10.7759/cureus.48968 -
Food Science & Nutrition Nov 2023This study used structural magnetic resonance imaging to analyze changes in the gray matter volume (GMV) of preterm-born (PTB) and term-born (TB) children to help...
This study used structural magnetic resonance imaging to analyze changes in the gray matter volume (GMV) of preterm-born (PTB) and term-born (TB) children to help elucidate the influence of magnesium sulfate treatment on the nervous system development. A total of 51 subjects were recruited, including 28 PTB and 23 TB children. The intelligence scale and MRI scan were completed at the corrected age of 10 to 16 years. A whole-brain voxel-wise analysis tested the main effect of the status (PTB without magnesium, PTB with magnesium, and TB) using a factorial design in SPM8. The mean volumes of the regions that showed significant group effects on the GMV after the FDR correction were extracted in the common space for each subject. Verbal and full-scale intelligence quotient scores were significantly lower for PTB children without magnesium than for TB children; however, the scores of PTB children with magnesium and TB children were almost identical. Compared with TB children, PTB children had significantly reduced left straight gyrus and left inferior frontal gyrus GMVs; however, the volumes of PTB children with magnesium were closer to those of TB children. Changes in the GMV of the left inferior frontal gyrus were significantly correlated with full-scale and verbal intelligence quotient scores, whereas the lower gestational age at the time of mgsou4 treatment led to a larger GMV of the left inferior frontal gyrus. Brain structural abnormalities could exist in PTB children. The GMVs of the left straight gyrus and left inferior frontal gyrus were significantly reduced in these children. The influence of magnesium sulfate treatment was not significant, but the cognitive levels of these children were significantly increased and almost identical to those of TB children. Initiation of magnesium sulfate treatment during gestation is negatively correlated with the left inferior frontal gyrus GMV.
PubMed: 37970388
DOI: 10.1002/fsn3.3630 -
Korean Journal of Anesthesiology Dec 2023Respiratory mechanics are often significantly altered in morbidly obese patients and magnesium sulfate (MgSO4) is a promising agent for managing several respiratory... (Randomized Controlled Trial)
Randomized Controlled Trial
Effect of magnesium sulfate on oxygenation and lung mechanics in morbidly obese patients undergoing bariatric surgery: a prospective double-blind randomized clinical trial.
BACKGROUND
Respiratory mechanics are often significantly altered in morbidly obese patients and magnesium sulfate (MgSO4) is a promising agent for managing several respiratory disorders. This study aimed to examine the effects of MgSO4 infusions on arterial oxygenation and lung mechanics in patients with morbid obesity undergoing laparoscopic bariatric surgery.
METHODS
Forty patients with morbid obesity aged 21-60 years scheduled for laparoscopic bariatric surgery under general anesthesia were randomly allocated to either the control (normal saline infusion) or MgSO4 group (30 mg/kg lean body weight [LBW] of 10% MgSO4 in 100 ml normal saline intravenously over 30 min as a loading dose, followed by 10 mg/kg LBW/h for 90 min). The primary outcome was intraoperative arterial oxygenation (ΔPaO2/FiO2). Secondary outcomes included intraoperative static and dynamic compliance, dead space, and hemodynamic parameters.
RESULTS
At 90 min intraoperatively, the Δ PaO2/FiO2 ratio and the Δ dynamic lung compliance were statistically significantly higher in the MgSO4 group (mean ± SE: 16.1 ± 1.0, 95% CI [14.1, 18.1] and 8.4 ± 0.5 ml/cmH2O, 95% CI [7.4, 9.4]), respectively), and the Δ dead space (%) was statistically significantly lower in the MgSO4 group (mean ± SE: -8.0 ± 0.3%, 95% CI [-8.6, -7.4]) (P < 0.001). No significant differences in static compliance were observed.
CONCLUSIONS
Although MgSO4 significantly preserved arterial oxygenation and maintained dynamic lung compliance and dead space in patients with morbid obesity, the clinical relevance is minimal. This study failed to adequately reflect the clinical importance of these results.
Topics: Humans; Obesity, Morbid; Magnesium Sulfate; Prospective Studies; Saline Solution; Lung; Bariatric Surgery
PubMed: 36539925
DOI: 10.4097/kja.22446 -
Drug Design, Development and Therapy 2024Magnesium sulfate, an intravenous adjuvant, has recently attracted immense attention in multimodal analgesia. Previous studies confirmed the crucial role of magnesium... (Randomized Controlled Trial)
Randomized Controlled Trial Clinical Trial
Effect of Magnesium Sulfate Infusion on Postoperative Quality of Recovery in Patients Undergoing Total Knee Arthroplasty: A Prospective, Double-Blind, Randomized Controlled Trial.
BACKGROUND
Magnesium sulfate, an intravenous adjuvant, has recently attracted immense attention in multimodal analgesia. Previous studies confirmed the crucial role of magnesium sulfate in postoperative pain and nociceptive hypersensitivity. However, the effect of magnesium sulfate in multimodal analgesia on the quality of recovery (QoR) for elderly patients has not been thoroughly studied. Therefore, the present experiment aimed to investigate the effect of continuous intravenous magnesium sulfate on the quality of postoperative recovery in elderly patients undergoing total knee arthroplasty (TKA).
PATIENTS AND METHODS
In this study, a total of 148 patients scheduled to undergo unilateral total knee arthroplasty were randomized into a magnesium sulfate group (Group M, n=68) and a control group (Group C, n=66) using a double-blind, randomized controlled trial. Before induction of anesthesia, Group M received intravenous magnesium sulfate (40 mg/kg) for 15 min, followed by a continuous infusion (15 mg/kg) until the end of the procedure. In the same manner, Group C received an infusion of the same amount of isotonic saline using the same method as the Group M.
RESULTS
Compared with Group C, Group M had significantly better QoR-15 scores on postoperative day 1(POD) than Group C ( <0.05). Analysis of the dimensions of QoR-15 scores indicated that Group M exhibited notably reduced levels of pain, and higher levels of emotional state and physical comfort than Group C ( <0.05). Furthermore, Group C had significantly higher numerical rating scale (NRS) scores at POD than Group M ( <0.05).
CONCLUSION
For elderly patients undergoing knee arthroplasty, magnesium sulfate can be used as an adjuvant in a multimodal analgesic regimen to reduce early postoperative pain and improve the quality of early postoperative recovery.
Topics: Humans; Aged; Magnesium Sulfate; Arthroplasty, Replacement, Knee; Prospective Studies; Analgesics; Pain, Postoperative; Double-Blind Method; Analgesics, Opioid
PubMed: 38560523
DOI: 10.2147/DDDT.S444896 -
Experimental and Therapeutic Medicine Jul 2024Models of inflammation, oxidative stress, hyperoxia and hypoxia have demonstrated that magnesium sulfate (MgSO), a commonly used drug in obstetrics, has neuroprotective...
Models of inflammation, oxidative stress, hyperoxia and hypoxia have demonstrated that magnesium sulfate (MgSO), a commonly used drug in obstetrics, has neuroprotective potential. In the present study, the effects of MgSO treatment on inflammation, oxidative stress and fetal brain histopathology were evaluated in an experimental rat model following sevoflurane (Sv) exposure during the mid-gestational period. Rats were randomly divided into groups: C (control; no injections or anesthesia), Sv (exposure to 2.5% Sv for 2 h), MgSO (administered 270 mg/kg MgSO intraperitoneally) and Sv + MgSO (Sv administered 30 min after MgSO injection). Inflammatory and oxidative stress markers were measured in the serum and neurotoxicity was investigated histopathologically in fetal brain tissue. Short-term mid-gestational exposure to a 1.1 minimum alveolar concentration of Sv did not significantly increase the levels of any of the measured biochemical markers, except for TNF-α. Histopathological evaluations demonstrated no findings suggestive of pathological apoptosis, neuroinflammation or oxidative stress-induced cell damage. MgSO injection prior to anesthesia caused no significant differences in biochemical or histopathological marker levels compared to the C and Sv groups. The present study indicated that short-term exposure to Sv could potentially be considered a harmless external stimulus to the fetal brain.
PubMed: 38827470
DOI: 10.3892/etm.2024.12574 -
Animals : An Open Access Journal From... Jul 2023The objective of this study was to investigate the effects of dietary supplementation with different types of potassium and magnesium on the reproductive performance,...
Dietary Supplementation with Different Types of Potassium and Magnesium during Late Gestation and Lactation Modulates the Reproductive Performance, Antioxidant Capacity, and Immune Function of Sows.
The objective of this study was to investigate the effects of dietary supplementation with different types of potassium and magnesium on the reproductive performance, antioxidant capacity, and immunity of sows. Forty-five Landrace × Yorkshire sows at the late gestation stage (85 d) were randomly assigned to three groups (n = 15). Sows in the control group (CON), potassium chloride and magnesium sulfate group (PM), and potassium-magnesium sulfate group (PMS) were fed with a basal diet, a basal diet supplemented with magnesium sulfate (0.20%) and potassium chloride (0.15%), or a basal diet supplemented with potassium-magnesium sulfate (0.45%), respectively. The results showed that dietary supplementation with PMS did not yield significant effects on the reproductive performance compared with the CON group ( > 0.05). However, it significantly elevated the level of insulin-like growth factor 1 (IGF-1) in plasma and immunoglobulin A (IgA) in colostrum ( < 0.05). Furthermore, PMS significantly augmented the activities of catalase (CAT) and superoxide dismutase (SOD) while reducing the levels of malondialdehyde (MDA) in comparison to the CON group ( < 0.05). Compared with the PM group, the PMS group significantly reduced the incidence rate of intrauterine growth restriction (IUGR) ( < 0.05) and significantly decreased the concentration of the proinflammatory cytokine (TNF-α) level in plasma ( < 0.05). These results indicated that dietary supplementation with PMS during late gestation could enhance sows' antioxidant capacity and the IgA level in colostrum. These findings will provide a theoretical reference for the use of magnesium and potassium in sow production to improve sows' health.
PubMed: 37443982
DOI: 10.3390/ani13132183 -
PloS One 2023Acid sulfate soil characterized by pyrite (FeS2) which produces high acidity (soil pH < 3.5) and release high amount of Al3+ and Fe2+. Application of 4 t ha-1 Ground...
Acid sulfate soil characterized by pyrite (FeS2) which produces high acidity (soil pH < 3.5) and release high amount of Al3+ and Fe2+. Application of 4 t ha-1 Ground Magnesium Limestone (GML), is a common rate used for acid sulfate soil by the rice farmers in Malaysia. Therefore, this study was conducted to evaluate the integral effect of ground magnesium limestone (GML) and calcium silicate and to determine the optimal combination on acid sulfate soils in Malaysia. The acid sulfate soils were incubated under the submerged condition for 120 days with GML (0, 2, 4, 6 t ha-1) in combination with calcium silicate (0, 1, 2, 3 t ha-1) arranged in a Completely Randomized Design (CRD). The soil was sampled after 30, 60, 90 and 120 days of incubation and analyzed for soil pH, exchangeable Al, Ca, Mg, K and available Si. A total of 2 out of 16 combinations met the desired soil requirement for rice cultivation. The desired chemical soil characteristics for rice cultivation are soil pH > 4, exchangeable Al < 2 cmolc Kg-1, exchangeable Ca > 2 cmolc kg-1, exchangeable Mg > 1 cmolc kg-1 and Si content > 43 mg kg-1. The combinations are i) 2 t ha-1 calcium silicate + 2 t ha-1 GML, and ii) 3 t ha-1 calcium silicate + 2 t ha-1 GML, respectively. These combination rates met the desired requirement of soil chemical characteristics for rice cultivation. Soil acidity was reduced by a gradual release of Ca2+ and SiO32- from calcium silicate continuously filling the exchange sites and reducing the potential of extra (free) H+ availability in the soil system. Combination of calcium silicate and GML, shows the ameliorative effect with; i) release of Ca, ii) binding of Al3+ making it inert Al-hydroxides and, iii) bind H+ to produce water molecules.
Topics: Calcium Carbonate; Magnesium; Sulfates; Heartburn; Oryza; Soil; Sulfur Oxides
PubMed: 37713375
DOI: 10.1371/journal.pone.0290703