Magnesium use on prophylaxis of vasospasm morbidity and the mortality rate in subarachnoid hemorrhage

Introduction

We propose this study in order to reach two points: the clinical incidence of vasospasm morbidity, confirmed by CT; and the mortality of subarachnoid hemorrhage (SAH) patients in 28 days [1]. It shows the comparison of a group of patients that used magnesium (Mg) (intervention, Group 1) with those that did not use Mg (control, Group 2).

Methods

After institutional approval and informed consent, a prospective, randomized, nonblind study was carried out between February and November 2008. The main goal of the study was to achieve a Mg serum concentration from 2.5 to 3.5 mg/dl, using a solution of Mg 2% (saline solution 5% 400 ml + MgSO₄ 10% 100 ml/24 hours), during the first 14 days of aneurysm rupture. Admission criteria: patients diagnosed with SAH and ΔT <96 hours. Exclusion criteria: patients with SAH and ΔT >96 hours.

Results

In a previous study evaluation we analysed a total of 56 patients with (n = 26 in Group 1 and n = 30 in Group 2) (Tables 1 and 2). Main results: Group 1 – vasospasm frequency 26.9% (n = 7) and mortality 19.2% (n = 5) in 28 days; Group 2 – vasospasm frequency 46.7% (n = 14) and mortality 33.3% (n = 10) in 28 days.

Table 1

Table 2

Conclusion

According to the outcome, we can conclude that Group 1 obtained greater protection on the vasospasm incidence and decrease of mortality in comparison with Group 2. The P value was not significant due to a still small number of patients.