TABLE 12-1 Relevant Data Identified for Magnesium

Reference

Type of Injury/Insult

Type of Study and Subjects

Treatment

Findings/Results

Tier 1: Clinical trials

Kidwell et al., 2009

Acute ischemic stroke

Multicenter, randomized, double-blind, placebo-controlled clinical trial (substudy of IMAGES trial)

Magnesium sulfate (MgSO4) solution (bolus dose of 16 mmol infused over 15 minutes, then 65 mmol/day) or matching amount of saline)

For all patients, baseline lesion volume measured by DWI (rb=0.654, p < 0.001) and perfusion-weighted imaging (r=0.805, p < 0.001) correlated with final infarct size.

At day 90, there was no significant difference between the MgSO4 group and placebo group in lesion growth, clinical outcome, or mortality rate. However, patients with poor clinical outcome tended to have greater percentage infarct growth (p=0.015) and absolute infarct growth (p=0.004).

na=104 patients with diffusion-weighted imaging (DWI) lesion volume of ≥ 3 mL

Although baseline serum glucose level correlated with infarct growth (p ≤ 0.028) in the MgSO4 group, higher glucose level was not detected in patients with growth of > 0% compared to those with growth of ≤ 0%. Serum glucose level was not significantly correlated with infarct growth in placebo patients.

No adverse effects were mentioned.

Wong et al., 2009

Aneurysmal subarachnoid hemorrhage (SAH)

Multi-center, randomized, placebo-controlled trial

MgSO4 infusion (80mmol/day) or normal saline for 10–14 days

Throughout the study, the treatment group had a higher plasma magnesium level than the control group (p < 0.001). The average plasma magnesium level in the treatment group was between 1.59–1.84 mmol/L, while the average in the control group ranged from 0.85–1.02 mmol/L.

n=22 patients who were simultaneously participating in an intravenous MgSO4 after aneurysmal SAH trial

Although the treatment group had higher levels of cerebrospinal fluid magnesium overall, the difference was significant only on day 2 and days 5–8 (p ≤ 0.035). The average levels of cerebrospinal fluid magnesium ranged from 1.22–1.278 mmol/L in the treatment group, and from 1.09–1.10 mmol/L in the control group; the increase ranged from 10.5–21.3%.

The treatment group also had significantly higher 24-hour urine levels of magnesium (p ≤ 0.005); the group’s average ranged from 47.9–77.3 mmol, while the control group’s average ranged from 2.7–3.5 mmol.

No adverse effects were mentioned.



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