title: The effect of intravenous magnesium sulfate on serum levels of N-terminal pro-brain natriuretic peptide (NT pro-BNP) in elective CABG with cardiopulmonary bypass.
abstract: BACKGROUND
  Nowadays, many patients undergo coronary artery bypass grafting (CABG) with a cardiopulmonary bypass (CPB); while a number of therapeutic agents have been used to suppress its related inflammatory process. Magnesium sulfate (MgSO4) solution has been used as an anti-inflammatory agent. Among the cardiac biomarkers, N-terminal pro brain natriuretic peptide (NT Pro-BNP) is one of the most widely recognized. We performed this study to assess the effect of MgSO4 solution on NT Pro-BNP levels in patients undergoing CABG with CPB.
  
  
  METHODS
  In a double-blind clinical trial, after IRB approval for ethical considerations, during a 12-month period, 88 adult patients aged 40-70 years qualified for the study after inclusion and exclusion criteria were considered. After random allocation of the patients between the two groups, anesthesia, surgical procedure, cardiopulmonary bypass (CPB) methods, and postoperative care were made as similar as possible; however, one group received a MgSO4 infusion (15 mg/kg/h) and the other group saline (placebo). Pre- and post-operative levels of NT Pro-BNP were assessed using an electrochemical luminescence immunoassay in an Elecsys 2010 (Roche, Indianapolis, IN, USA). The results were compared using a Student's t-test. A P value less than 5% was considered significant.
  
  
  RESULTS
  The MgSO4 group had shorter postoperative mechanical ventilation, lower postoperative morphine requirements and lower postoperative pain scores. Also, 24 h postoperative NT Pro-BNP levels were significantly lower in the MgSO4 group.
  
  
  CONCLUSIONS
  Administration of MgSO4 in elective CABG with CPB can decrease the postoperative NT Pro-BNP levels; also, it decreases their time of postoperative mechanical ventilation.
authors: Anesthesiology Research Center and Anesthesiology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran, alidabbagh@yahoo.com.
authors: Ali
authors: A
authors: Dabbagh
authors: Ehsan
authors: E
authors: Bastanifar
authors: Mahnoosh
authors: M
authors: Foroughi
authors: Samira
authors: S
authors: Rajaei
authors: Ali Asghar
authors: AA
authors: Keramatinia
mesh_terms: D061605:Administration, Intravenous; D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass / Q000379:methods*; D001026:Coronary Artery Bypass / Q000379:methods*; D004311:Double-Blind Method; D017558:Elective Surgical Procedures / Q000379:methods; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011183:Postoperative Complications / Q000097:blood; D011184:Postoperative Period
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D008278:Magnesium Sulfate
references: Singapore Med J. 2010 May;51(5):381-8
references: 20593142
references: Magnes Res. 2009 Mar;22(1):21-31
references: 19441271
references: Br J Anaesth. 2009 Oct;103(4):465-7
references: 19749114
references: Ann Fr Anesth Reanim. 2011 Jan;30(1):47-50
references: 21236623
references: Indian J Anaesth. 2009 Apr;53(2):197-203
references: 20640123
references: J Cardiothorac Vasc Anesth. 2012 Aug;26(4):631-6
references: 22285123
references: Eur J Cardiothorac Surg. 2011 Sep;40(3):722-9
references: 21353585
references: Acta Anaesthesiol Scand. 2009 Sep;53(8):1088-91
references: 19519724
references: J Cardiothorac Vasc Anesth. 2009 Apr;23(2):223-31
references: 18930659
references: J Cardiothorac Vasc Anesth. 2009 Jun;23(3):384-93
references: 19054695
references: J Perianesth Nurs. 2010 Oct;25(5):290-5
references: 20875883
references: Semin Cardiothorac Vasc Anesth. 2009 Dec;13(4):231-7
references: 19948518
references: Chest. 2002 Mar;121(3):921-31
references: 11888978
references: J Am Coll Cardiol. 2007 May 15;49(19):1934-42
references: 17498578
references: Acta Anaesthesiol Scand. 2008 Nov;52(10):1348-52
references: 19025526
references: J Cardiothorac Vasc Anesth. 2012 Jun;26(3):395-402
references: 22206712
references: Anesth Analg. 1999 Jun;88(6):1213-9
references: 10357321