Effect of magnesium on prophylaxis of vasospasm, morbidity, and mortality in subarachnoid hemorrhage patients

Introduction

We propose this study in order to reach two end points: (a) vasospasm clinical incidence, confirmed by CT; and (b) the mortality of these patients in 28 days. The study shows a comparison of a group of patients that used Mg (Intervention Group 1) from those that did not (Control Group 2).

Methods

After institutional approval and informed consent, a prospective, randomized, nonblind study was performed 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% (SG 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 26 in Group 1 and 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 (abstract P54)

Table 2 (abstract P54)

Conclusion

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