Document Detail


Prophylactic magnesium for improving neurologic outcome after aneurysmal subarachnoid hemorrhage: systematic review and meta-analysis.
MedLine Citation:
PMID:  23192249     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Neurologic disability is common after aneurysmal subarachnoid hemorrhage (aSAH). Our objective was to systematically review the prophylactic use of magnesium to improve neurologic outcomes in these patients.
METHODS: We searched MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials to June 2012 for randomized and quasi-randomized controlled trials of intravenous magnesium in adults after aSAH, given before radiologic vasospasm or delayed cerebral ischemia (DCI) and compared with any control group. Two reviewers independently extracted data on study population, interventions, and outcomes (good neurologic outcome [primary outcome], cerebral infarction, DCI, radiographic vasospasm, mortality, adverse events). Analyses used random-effects models.
RESULTS: Of 702 citations, 13 trials (n = 2401) met the selection criteria. Meta-analyses showed that magnesium did not increase the probability of good neurologic outcome (risk ratio [RR], 1.02; 95% confidence interval [CI], 0.97-1.07; P = .49; 12 trials, n = 2345) or decrease the risks of cerebral infarction (RR, 0.69; 95% CI, 0.46-1.05; P = .08; 5 trials, n = 572), radiographic vasospasm (RR, 0.86; 95% CI, 0.71-1.04; P = .13; 7 trials, n = 438), or mortality (RR, 0.98; 95% CI, 0.80-1.20; P = .86; 11 trials, n = 2092). Magnesium did reduce the risk of DCI (RR, 0.73; 95% CI, 0.56-0.96; P = .02; 10 trials, n = 1095). Data on adverse events were generally sparse.
CONCLUSIONS: Despite decreasing the incidence of DCI in patients with aSAH, prophylactic intravenous magnesium does not improve neurologic outcome or decrease cerebral infarction, radiographic vasospasm, or mortality.
Authors:
Eyal Golan; Daniela N Vasquez; Niall D Ferguson; Neill K J Adhikari; Damon C Scales
Related Documents :
23676799 - Individual empowerment in overweight and obese patients: a study protocol.
23230879 - Safety and efficacy of ultrasonography before and during percutaneous dilatational trac...
24086339 - Depressive symptoms and risk of new cardiovascular events or death in patients with myo...
23531029 - Treatment of frontal fibrosing alopecia and lichen planopilaris: a systematic review.
7380759 - The experimental modification of sonorous breathing.
24048399 - Bipolar disorder - from endophenotypes to treatment.
17464679 - Judged effectiveness of differing antidepressant strategies by those with clinical depr...
15266189 - Cognitive-behavioral psychotherapy for anxiety and depressive disorders in children and...
23676799 - Individual empowerment in overweight and obese patients: a study protocol.
Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2012-11-26
Journal Detail:
Title:  Journal of critical care     Volume:  28     ISSN:  1557-8615     ISO Abbreviation:  J Crit Care     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-07     Completed Date:  2013-09-20     Revised Date:  2013-12-20    
Medline Journal Info:
Nlm Unique ID:  8610642     Medline TA:  J Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  173-81     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Brain Ischemia / prevention & control
Clinical Trials as Topic
Humans
Magnesium / administration & dosage,  therapeutic use*
Nervous System Diseases / physiopathology,  prevention & control
Subarachnoid Hemorrhage / drug therapy*,  physiopathology
Treatment Outcome
Vasospasm, Intracranial / prevention & control
Chemical
Reg. No./Substance:
I38ZP9992A/Magnesium
Comments/Corrections
Comment In:
J Crit Care. 2013 Dec;28(6):1102   [PMID:  24035009 ]
J Crit Care. 2013 Dec;28(6):1101   [PMID:  23867720 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  High bone mass in the STR/ort mouse results from increased bone formation and impaired bone resorpti...
Next Document:  Mesh Achilles tendon lengthening - a new method to treat equinus deformity in patients with spastic ...