Cerebral spinal fluid and serum ionized magnesium and calcium levels in preeclamptic women during administration of magnesium sulfate

Apostol, Alexander; Apostol, Radu; Али, Е Ш Шариф; Choi, A.; Ehsuni, Nazanin; Hu, Bin; Li, Lei; Altura, Bella T.; Altura, Burton M.

doi:10.1016/j.fertnstert.2009.02.024

Cited by 23 publications

(19 citation statements)

References 62 publications

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“…We question whether the lack of efficacy in some of the studies is the result of a dose of magnesium sulfate that is insufficient to block voltage-sensitive calcium channels. 17,18 Glover et al 19 described the feasibility of administering a loading dose of 35 mg/kg and 25 mg/kg/hr intravenous magnesium for up to 3 days in patients with status asthma. This was a heterogeneous group with a large variation in dosing regimen and duration, and no patient experienced cardiovascular adverse affects.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Short-Term Infusion of Magnesium Sulfate in Pediatric Patients With Status Asthmaticus

Irazuzta

Egelund

Wassil

et al. 2012

The Journal of Pediatric Pharmacology and Therapeutics

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OBJECTIVE This report describes the feasibility of high-dose magnesium sulfate infusion in pediatric patients with status asthmaticus. METHODS Retrospective chart review over a 3-year period of all patients younger than 18 years of age with status asthmaticus who underwent a high-dose magnesium sulfate infusion for 4 hours. All patients were breathing spontaneously but were refractory to conventional therapy. The magnesium sulfate infusion regimen was 50 mg/kg (for patients weighing .30 kg) or 75 mg/kg (for those weighing 30 kg) over a period of 30 to 45 minutes, followed by a continuous infusion of 40 mg/kg/hr for 4 hours. Information regarding vital and clinical respiratory signs, serum magnesium (SrMg), ionized magnesium (iMg), electrocardiograms, and cardiac troponin levels were retrieved. We analyzed the relationship between SrMg and iMg by using linear regression analysis. RESULTS Nineteen patients were included. At the end of the infusion, SrMg levels were 4.4 6 0.8 mg/ dL, and iMg levels were 0.95 6 0.2 mmol/L. SrMg levels only moderately predicted iMg (r 2 ¼ 0.541). There were no reports of hypotension, respiratory failure, neurological problems, or nausea. Discomfort at the site of infusion was reported in three cases. Troponin levels (n ¼ 12) and electrocardiograms (n ¼ 12), when available, were noted at the end of the infusion and were normal in all patients p¼0.01. CONCLUSIONS In this case series, short-term high-dose administration of magnesium sulfate in the context of status asthmaticus was feasible, and we did not observe clinical complications with its use. Total SrMg was inadequate to reflect the active form of magnesium, iMg. The dose used achieved theoretical therapeutic levels of iMg.INDEX TERMS asthma, feasibility, infusion, magnesium sulfate, status asthmaticus J Pediatr Pharmacol Ther 2012;17(2):150-154

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Section: Discussionmentioning

confidence: 99%

Feasibility of Short-Term Infusion of Magnesium Sulfate in Pediatric Patients With Status Asthmaticus

Irazuzta

Egelund

Wassil

et al. 2012

The Journal of Pediatric Pharmacology and Therapeutics

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“…Last, it must be entertained that a great deal of the cellular tissue deficits in Mg 2ϩ noted recently in diverse cardiovascular pregnancy-vascular aberrations, gestational diabetes, and type 1 and 2 diabetic-related vascular diseases (for specifics, see Refs. 3,4,11,12,17,23,24,40,41) may be, in large measure, due to disturbances in vascular and endothelial cell membrane N-SMase and the inability of these cells to generate and release sphingolipids needed for magnesium transport and homeostasis, rather than renal loss of magnesium, per se. In view of the latter clinical possibilities, we believe this hypothesis deserves further investigation.…”

Section: Discussionmentioning

confidence: 99%

Sphingolipids regulate [Mg²⁺]_o uptake and [Mg²⁺]_i content in vascular smooth muscle cells: potential mechanisms and importance to membrane transport of Mg²⁺

Zheng

Li²,

Altura

et al. 2011

American Journal of Physiology-Heart and Circulatory Physiology

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Sphingolipids have a variety of important signaling roles in mammalian cells. We tested the hypothesis that certain sphingolipids and neutral sphingomyelinase (N-SMase) can regulate intracellular free magnesium ions ([Mg2+]i) in vascular smooth muscle (VSM) cells. Herein, we show that several sphingolipids, including C2-ceramide, C8-ceramide, C16-ceramide, and sphingosine, as well as N-SMase, have potent and direct effects on content and mobilization of [Mg2+]i in primary cultured rat aortic smooth muscle cells. All of these sphingolipid molecules increase, rapidly, [Mg2+]i in these vascular cells in a concentration-dependent manner. The increments of [Mg2+]i, induced by these agents, are derived from influx of extracellular Mg2+ and are extracellular Ca2+ concentration-dependent. Phospholipase C and Ca2+/calmodulin/Ca2+-ATPase activity appear to be important in the sphingolipid-induced rises of [Mg2+]i. Activation of certain PKC isozymes may also be required for sphingolipid-induced rises in [Mg2+]i. These novel results suggest that sphingolipids may be homeostatic regulators of extracellular Mg2+ concentration influx (and transport) and [Mg2+]i content in vascular muscle cells.

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“…Similarly, Apostol et al (2010) observed that injection of magnesium sulfate to preeclamptic women does not cause a significant change in calcium level, compared to women with normal blood pressure 14 . On the other hand, showed that treatment with magnesium sulfate leads to decrease in total and ionic calcium levels in preeclamptic women compared with women with normal blood pressure, so that parathormone hormone was increased in their serum which in turn caused excretion of urine calcium 15 .…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Total Albumin and Calcium Level between Preeclamptic Women Undergoing Magnesium Sulfate Therapy and with Normal Pregnancies

Emami¹,

Najib²,

Poordast³

et al. 2015

Biosci., Biotech. Res. Asia

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Magnesium sulfate is used for seizure therapy and profilaxy in women with eclampsia and preeclampsia worldwide. Magnesium has effect on calcium modulation and also there are antithesis reports about alternation between magnesium sulfate therapy and decreased serum calcium level. Decreased in serum calcium level may cause some complications. The present study determines whether maternal serum level of calcium and albumin in patients with preeclampsia are lower than matched control subjects. Thirty patients with preeclampsia who were candidate for received magnesium sulfate therapy compared with 30 normal pregnant women as a control group. Serum calcium and albumin concentration were determined in 3 ml of venous blood sample that was taken before magnesium sulfate therapy, during and 24 hrs after discontinuation of therapy in preeclamptic women and also before and 8 hrs after delivery in normal pregnant women. Findings show no significance difference of maternal and gestational ages between the two groups. The change in mean concentration of albumin, total calcium level, and corrected serum calcium level was observed just significantly at the albumin level 24 hrs after the termination of therapy in preeclamptic group (3 mg/dl, 2.7 mg/dl) P=0.03. There is no any correlation between others items in two groups. In both two groups serum calcium level is more before delivery than after. In the preeclamptic group (9.1 mg/dl, 9 mg/dl) P=0.00 and in normotensive group (9.3 mg/dl, 9 mg/dl) P=0.00. According to this small group study magnesium sulfate therapy in preeclamptic women doesn't redounded to change in serum calcium level, but may lead to increased albumin level after delivery in control subject and also after discontinuation of the therapy in patients groups respectively. Keywords: Preeclampsia, Calcium, Albumin, Magnesium sulfate Preeclampsia has a high prevalence among pregnant women and it can lead to serious complications for them or even death 1, 2 . Magnesium sulfate is a common cure for prevention the eclampsia in these patients 3 . Ionic calcium is antagonized by magnesium ions 4,5 . Therefore, it seems that magnesium sulfate can decrease serum calcium and its adverse effects in preeclamptic patients. Decreased calcium serum is associated with some different effects such as convulsion, muscle spasm especially in the larynx, psychological problems, change in vital signs, and cardiac arrest; so that, it can potentially threaten life 6 . There are also some controversial reports on low calcium contents in preeclamptic patients [7][8][9][10] . In case of low calcium contents, magnesium sulfate can intensify the condition and cause serious complications 6 . Halhali et al. (2001) showed that preeclamptic patients have a low level of 2104 ASKARY et al., Biosci., Biotech. Res. Asia, Vol. 12(3), 2103-2110 (2015) parathormone and injection of magnesium sulfate can increase Calcitonin gene related peptide in them which leads to hypocalcemia 11 . Huang et al. (2004) injected magnesium sulfate to pregnant women...

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Cerebral spinal fluid and serum ionized magnesium and calcium levels in preeclamptic women during administration of magnesium sulfate

Cited by 23 publications

References 62 publications

Feasibility of Short-Term Infusion of Magnesium Sulfate in Pediatric Patients With Status Asthmaticus

Feasibility of Short-Term Infusion of Magnesium Sulfate in Pediatric Patients With Status Asthmaticus

Sphingolipids regulate [Mg²⁺]_o uptake and [Mg²⁺]_i content in vascular smooth muscle cells: potential mechanisms and importance to membrane transport of Mg²⁺

A Comparative Study of Total Albumin and Calcium Level between Preeclamptic Women Undergoing Magnesium Sulfate Therapy and with Normal Pregnancies

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Cerebral spinal fluid and serum ionized magnesium and calcium levels in preeclamptic women during administration of magnesium sulfate

Cited by 23 publications

References 62 publications

Feasibility of Short-Term Infusion of Magnesium Sulfate in Pediatric Patients With Status Asthmaticus

Feasibility of Short-Term Infusion of Magnesium Sulfate in Pediatric Patients With Status Asthmaticus

Sphingolipids regulate [Mg2+]o uptake and [Mg2+]i content in vascular smooth muscle cells: potential mechanisms and importance to membrane transport of Mg2+

A Comparative Study of Total Albumin and Calcium Level between Preeclamptic Women Undergoing Magnesium Sulfate Therapy and with Normal Pregnancies

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Sphingolipids regulate [Mg²⁺]_o uptake and [Mg²⁺]_i content in vascular smooth muscle cells: potential mechanisms and importance to membrane transport of Mg²⁺