Vivek Wadhawa1, Manish Hinduja2, Sandip Singh Rana3, Anand Kumar Mishra4, Sarin Mathew5, Goverdhan Dutt Puri6, Reema Tavar7, Amit Mishra8
BACKGROUND
Postoperative Junctional Ectopic Tachycardia (JET) remains one of the most common arrhythmias (8%-20%) after paediatric cardiac surgery. JET is associated with hemodynamic instability, longer mechanical ventilation time and longer stays in the Cardiac Intensive Care Unit (ICU).
AIM
The aim of this study is to evaluate the effect of prophylactic administration of magnesium on the occurrence of postoperative arrhythmias in patients undergoing intracardiac repair for Tetralogy of Fallot and to determine the incidence of hypomagnesaemia in paediatric patients undergoing cardiac surgery who require CPB.
METHODS
Forty five patients with Tetralogy of Fallot undergoing intracardiac repair were enrolled to receive saline, 25mg/kg and 50mg/kg of Magnesium as three groups intraoperatively. Postoperative ECG monitored for JET and magnesium levels measured.
RESULTS
Hypomagnesaemia was present in 28% of patients. None of the patients who were administered magnesium developed hypomagnesaemia. The incidence of JET was found to be increased (53.3%) in the placebo group as compared to 13.3% and 6.7% in the groups receiving 25 and 50mg/kg of magnesium (p<0.001). Eleven patients having JET 7 (64%) had hypomagnesaemia and rest of the 4(36%) occurred in patients with normal magnesium levels (p<0.01). The mean mechanical ventilation time and the mean length of ICU stay were both prolonged those with hypomagnesaemia. The mean mechanical ventilation time and length of ICU stay were both prolonged in the patients with JET (p<.001)
CONCLUSIONS
Hypomagnesemia is one of the factors responsible for JET and in turn with prolonged ICU stay and prolonged mechanical ventilation.
