Nikolaus A Haas1, Jan Kemke, Ingram Schulze-Neick, Peter E Lange. 1. Department of Congenital Heart Defects/Paediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. nikolaus_haas@health.qld.gov.au
Abstract
OBJECTIVE: To investigate the dose-related effects of magnesium on pulmonary vascular resistance and associated changes in cardiac output in porcine micro-embolic pulmonary hypertension. DESIGN: Prospective, interventional animal study. SETTING: University animal laboratory. SUBJECTS: Forty anaesthetised and ventilated piglets. INTERVENTIONS: Right heart catheterisation for the measurement of cardiac output, pulmonary artery pressure, central venous pressure and pulmonary capillary wedge pressure; arterial cannulation for measurement of arterial pressures and ionised magnesium levels; calculation of pulmonary and systemic vascular resistance before and after induction of acute pulmonary micro-embolism, and without or with the administration of magnesium (0.5, 1.0, 2.0 mmol/kg bolus and 1 mmol/kg bolus followed by 1 mmol/kg per h continuous infusion). MEASUREMENTS AND MAIN RESULTS: The bolus administration of increasing doses of magnesium (0.5, 1.0, 2.0 mmol/kg) was associated with an increase in ionised serum magnesium levels and a dose-dependent decrease of mean pulmonary arterial pressure, an increase of cardiac output and a decrease of pulmonary vascular resistance. This effect was sustained after bolus administration (1 mmol/kg) followed by a continuous infusion of magnesium (1 mmol/kg per h). CONCLUSIONS: Magnesium has a directly dose-dependent beneficial effect on the circulation in acute embolic pulmonary hypertension and improves cardiocirculatory impairment in massive pulmonary embolism (PE).
OBJECTIVE: To investigate the dose-related effects of magnesium on pulmonary vascular resistance and associated changes in cardiac output in porcine micro-embolic pulmonary hypertension. DESIGN: Prospective, interventional animal study. SETTING: University animal laboratory. SUBJECTS: Forty anaesthetised and ventilated piglets. INTERVENTIONS: Right heart catheterisation for the measurement of cardiac output, pulmonary artery pressure, central venous pressure and pulmonary capillary wedge pressure; arterial cannulation for measurement of arterial pressures and ionised magnesium levels; calculation of pulmonary and systemic vascular resistance before and after induction of acute pulmonary micro-embolism, and without or with the administration of magnesium (0.5, 1.0, 2.0 mmol/kg bolus and 1 mmol/kg bolus followed by 1 mmol/kg per h continuous infusion). MEASUREMENTS AND MAIN RESULTS: The bolus administration of increasing doses of magnesium (0.5, 1.0, 2.0 mmol/kg) was associated with an increase in ionised serum magnesium levels and a dose-dependent decrease of mean pulmonary arterial pressure, an increase of cardiac output and a decrease of pulmonary vascular resistance. This effect was sustained after bolus administration (1 mmol/kg) followed by a continuous infusion of magnesium (1 mmol/kg per h). CONCLUSIONS:Magnesium has a directly dose-dependent beneficial effect on the circulation in acute embolic pulmonary hypertension and improves cardiocirculatory impairment in massive pulmonary embolism (PE).
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