Magnesium therapy improves thromboelastographic findings before liver transplantation: a preliminary study.
OBJECTIVE
Patients undergoing liver transplantation may be predisposed to hypomagnesemia and present a bleeding tendency. There are evidences suggesting that magnesium is a crucial constituent of the blood coagulation cascade and has a pro-coagulant activity. The aim of this study was to investigate the effect of magnesium therapy on thromboelastography (TEG) in patients undergoing liver transplantation.


METHODS
27 patients scheduled for liver transplantation were enrolled. 1.5 g of magnesium sulfate, diluted in normal saline, were infused to all patients over five minutes in the operating room, before skin incision. The TEG findings immediately before and ten minutes after the magnesium infusion were compared.


RESULTS
The TEG findings showed general hypocoagulability before magnesium therapy. The K time and coagulation times (r+k) were shortened significantly from 641.6 +/- 505.9 (mean +/- SD) to 464.6 +/- 387.7 sec and from 1664.7 +/- 772.5 to 1362.2 +/- 487.1 sec respectively (P < 0.05); the maximal amplitude, and TEG index showed significant increases from 38.5 +/- 13.5 to 45.3 +/- 12.2 mm and from -3.4 +/- 2.6 to -1.9 +/- 1.8 respectively after magnesium therapy (P < 0.01). R time, alpha angle and LY60 were not different after magnesium therapy.


CONCLUSIONS
Magnesium therapy significantly improved TEG findings suggestive of a general hypocoagulable state towards normal in patients about to receive liver transplantation.
Choi
Jong H
JH
Department of Anesthesiology, School of Medicine, The Catholic University of Korea, Kangnam Saint Mary's Hospital, 505 Banpo-Dong, Seocho-Gu, Seoul, Korea 137-040.
Lee
Jaemin
J
Park
Chong M
CM
D000758:Anesthesia; D001777:Blood Coagulation / Q000187:drug effects; D006801:Humans; D016031:Liver Transplantation / Q000502:physiology*; D008274:Magnesium / Q000627:therapeutic use*; D011188:Potassium / Q000097:blood; D013916:Thrombelastography
D008274:Magnesium; D011188:Potassium