Document Detail


Successful resuscitation of hypermagnesaemic asystolic cardiac arrest with the use of early transvenous cardiac pacemaker: a case report.
MedLine Citation:
PMID:  16498146     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 63 year old woman presented to the emergency department (ED) with 1 week of progressive dyspnoea, constipation, and generalized weakness. She had undergone spinal fustion surgery 10 days previously, and had a history of chronic renal insufficiency. The patient had been using milk of magnesia and magnesium citrate in unknown amounts to alleviate her constipation over this time frame. During her ED stay she became progressively hypotensive and bradycardic, and despite aggressive resuscitative measures she suffered an asystolic arrest 1 hour into her ED course. She was resuscitated with conventional therapy, but her haemodynamic profile did not improve significantly until transvenous cardiac pacing was employed. Her magnesium level was 10.4 mmol/l. Treatment of magnesium overload has focused upon haemodialysis, forced diuresis, and the use of intravenous calcium salts. Case reports have previously documented survival of moderately to severely ill patients when these modalities have been used. Likewise, failure of resuscitation despite use of these methods has been previously noted. To our knowledge, this is the first reported case clearly demonstrating the efficacy of transvenous cardiac pacing to successfully resuscitate a patient upon whom multiple vasopressors, fluids, and calcium previously had no clear effect.
Authors:
M A Miller; C S Crystal; J Helphenstine; S E Young
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Emergency medicine journal : EMJ     Volume:  23     ISSN:  1472-0213     ISO Abbreviation:  Emerg Med J     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-24     Completed Date:  2006-04-10     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  100963089     Medline TA:  Emerg Med J     Country:  England    
Other Details:
Languages:  eng     Pagination:  e22     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Darnall Army Community Hospital, Fort Hood 76544, USA. michael.miller3@amedd.army.mil
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MeSH Terms
Descriptor/Qualifier:
Cardiopulmonary Resuscitation / instrumentation*
Female
Heart Arrest / therapy*
Humans
Magnesium / blood
Middle Aged
Pacemaker, Artificial*
Systole
Chemical
Reg. No./Substance:
7439-95-4/Magnesium
Comments/Corrections

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


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