Transcription of マグネシウム - JSEPTIC
1 ICU Magnesium in critical illness:metabolism, assessment, and treatmentIntensive Care Med (2002) 28:667 679 Magnesium Essentials for AnesthesiologistsAnesthesiology 2011; 114:971 93 2 4 1932 ICU 21-28g Mg 60 20 60 7 33 /dl ( mM) Functions 1 IP3 inositoltriphosphate 2 3 NMDA receptor 4 5 Ca 6 Na-Kion pump 7-11% ICU 65% Medical ICU Association of hypomagnesemiaand mortality in acutely ill medical ;21(2):203-9.
2 Surgical ICU Severehypomagnesemia( ) Hypomagnesemia in patients in postoperativeintensive 1989;95;391-397 ( ) Mg Mg Chvostek`ssignTrousseau`s sign Torsadesde pointes Mg free TPNR efeedingsyndrome Mg free TPN 1 mEq/L 15mEq/L Loop Thiazide A B Hungry bone
3 Volume infusion SIADH ICU 50 Emergency 8-12mM Mg over 1-2min40mM Mg over next 5hSeverely ill 40mM Mg on day 116-24mM Mg on days 2-5 Oral maintenance12-24mM per day 2 4g MgSO4 5 10 10g 6 10g 24 .12 MgSO4 1g/ 10 PPI ( FDA) FDA 3 2 PPI 1 FDA 38 3 1 1/4 PPI PPI 3 Hypomagnesemiainduced by Several Proton-Pump Inhibitors PPI Omeprazole,pantoprazole,lansoprazole BroerenM A et al.
4 Ann Intern Med 2009;151:755-756 PPI 3mg/dl( ) MgSO4 30g (2mM ) 6 12mg/dl 5mM 14 18mg/dl 80 mg/dL 30 mg/dL HD 10 10 20mL
5 PreeclampsiaDo women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomisedplacebocontrolled trialLancet 2002; 359: 1877 90 Torsadesde Pointes first line TdP RCT clinical trial Circulation 77,NO 2, 392-397, 1988 12 TdP 9 2g 1 5 TdP 3 5-15 Treatment of torsadede pointes with magnesium sulfateInterventions for prevention of post-operative atrialfibrillation and its complications after cardiac surgery.
6 A meta-analysisEuropean Heart Journal (2006) 27, 2846 2857 trial (OR , 95% ) RCT meta-analysis (OR , 95% CI ), trial (P )Atrial Fibrilation after Cardiac Surgery atrialfibrillation, postoperative cardiac arrhythmias Standard Therapy American College of cardiology, AHA, American college of Chest Physicians, European society of Cardiology European Association for Cardio-Thoracic Surgery atrialfibrillation SAHM agnesium DCI delayed cerebral ischemia 34 (hazard ratio, ; 95% CI, to ) 3 23 (risk ratio.)
7 95% CI, to ) Magnesium Sulfate in AneurysmalSubarachnoid Hemorrhage A Randomized Controlled TrialStroke 2005, 36:1011-1015 SAH Magnesium placebo Intravenous Magnesium Sulphatefor AneurysmalSubarachnoid Hemorrhage (IMASH)Stroke. 2010;41 in AneurysmalSubarachnoid Hemorrhage [MASH] II European Union Drug Regulating Authorities Clinical Trial 1200 AsthmaUsefulness of inhaled magnesium sulfate in the coadjuvantmanagement of severe asthma crisis in an emergency departmentPulmonary Pharmacology & Therapeutics 23 (2010) 432-437 ( -agonist ) FEV1%(69 13 vs.
8 61 12, p< ),SpO2(92 4 vs. 88 5%, p< ) (5 vs. 13, p< , RR 95% CI ) Randomized Controlled Trial Acute Severe Asthma : A Multicenter IV Magnesium Sulfate in the Treatment of ( -agonist ) 2g 240 FEV1 ( : ) ( , ; 95% CI, to ; p = )FEV1< 25% ( , ; 95% CI, to ; p = ) Chest 2002;122;489-497
