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https://hdl.handle.net/2440/5137
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dc.contributor.author | Moran, J. | - |
dc.contributor.author | Gallagher, J. | - |
dc.contributor.author | Peake, S. | - |
dc.contributor.author | Cunningham, D. | - |
dc.contributor.author | Salagaras, M. | - |
dc.contributor.author | Leppard, P. | - |
dc.date.issued | 1995 | - |
dc.identifier.citation | Critical Care Medicine, 1995; 23(11):1816-1824 | - |
dc.identifier.issn | 0090-3493 | - |
dc.identifier.issn | 1530-0293 | - |
dc.identifier.uri | http://hdl.handle.net/2440/5137 | - |
dc.description.abstract | <h4>Objective</h4>To compare the efficacy of parenteral magnesium sulfate vs. amiodarone in the therapy of atrial tachyarrhythmias in critically ill patients.<h4>Design</h4>Prospective, randomized study.<h4>Setting</h4>Multidisciplinary intensive care unit (ICU) at a university teaching hospital.<h4>Patients</h4>Forty-two patients, 21 medical and 21 surgical, of mean (SD) age 67 +/- 15 yrs and mean Acute Physiology and Chronic Health Evaluation II score of 22 +/- 6, with atrial tachyarrhythmias (ventricular response rate of > or = 120 beats/min) sustained for > or = 1 hr.<h4>Interventions</h4>After correction of the plasma potassium concentration to > or = 4.0 mmol/L, patients were randomly allocated to treatment with either a) magnesium sulfate 0.037 g/kg (37 mg/kg) bolus followed by 0.025 g/kg/hr (25 mg/kg/hr); or b) amiodarone 5 mg/kg bolus and 10 mg/kg/24-hr infusion. Therapeutic plasma magnesium concentration in the magnesium sulfate group was 1.4 to 2.0 mmol/L. Therapeutic end point was conversion to sinus rhythm over 24 hrs.<h4>Measurements and main results</h4>At study entry (time 0), initial mean ventricular response rate and systolic blood pressure were 151 +/- 16 (SD) beats/min and 127 +/- 30 mm Hg in the magnesium sulfate group vs. 153 +/- 23 beats/min and 123 +/- 23 mm Hg in the amiodarone group, respectively (p = .8 and .65). Plasma magnesium (time 0) was 0.84 +/- 0.20 vs. 1.02 +/- 0.22 mmol/L in the magnesium and amiodarone group, respectively (p = .1). Eight patients had chronic dysrhythmias (magnesium 3, amiodarone 5). Excluding the two patient deaths (amiodarone group, time 0 + 12 to 24 hrs), no significant change in systolic blood pressure subsequently occurred in either group. In the magnesium group, mean plasma magnesium concentrations were 1.48 +/- 0.36, 1.82 +/- 0.41, 2.16 +/- 0.45, and 1.92 +/- 0.49 mmol/L at time 0 + 1, 4, 12 and 24 hrs, respectively. By logistic regression, the probability of conversion to sinus rhythm was significantly better for magnesium than for amiodarone at time 0 + 4 (0.6 vs. 0.44), 12 (0.72 vs. 0.5), and 24 (0.78 vs. 0.5) hrs. In patients not converting to sinus rhythm, a significant decrease in ventricular response rate occurred at time 0 + to 0.5 hrs (mean decrease 19 beats/min, p = .0001), but there was no specific treatment effect between the magnesium and the amiodarone groups; thereafter, there was no significant reduction in ventricular response rate over time in either group.<h4>Conclusions</h4>Intravenous magnesium sulfate is superior to amiodarone in the conversion of acute atrial tachyarrhythmias, while initial slowing of ventricular response rate in nonconverters appears equally efficacious with both agents. | - |
dc.description.statementofresponsibility | John L. Moran, John Gallagher, Sandra L. Peake, David N. Cunningham, Mary Salagaras and Phil Leppard | - |
dc.language.iso | en | - |
dc.publisher | Williams & Wilkins | - |
dc.source.uri | http://dx.doi.org/10.1097/00003246-199511000-00005 | - |
dc.subject | Humans | - |
dc.subject | Tachycardia | - |
dc.subject | Magnesium | - |
dc.subject | Magnesium Sulfate | - |
dc.subject | Amiodarone | - |
dc.subject | Anti-Arrhythmia Agents | - |
dc.subject | Treatment Outcome | - |
dc.subject | Infusions, Parenteral | - |
dc.subject | APACHE | - |
dc.subject | Prospective Studies | - |
dc.subject | Aged | - |
dc.subject | Aged, 80 and over | - |
dc.subject | Middle Aged | - |
dc.subject | Intensive Care Units | - |
dc.subject | Female | - |
dc.subject | Male | - |
dc.title | Parenteral magnesium sulfate versus amiodarone in the therapy of atrial tachyarhythmias: A prospective randomized study | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1097/00003246-199511000-00005 | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Moran, J. [0000-0003-2311-0440] | - |
dc.identifier.orcid | Peake, S. [0000-0001-6682-7973] | - |
Appears in Collections: | Aurora harvest Statistics publications |
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