Sunil K. Bhudia, MD, Delos M. Cosgrove, MD, Richard I

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Presentation transcript:

Magnesium as a neuroprotectant in cardiac surgery: A randomized clinical trial Sunil K. Bhudia, MD, Delos M. Cosgrove, MD, Richard I. Naugle, PhD, Jeevanantham Rajeswaran, MSc, Buu-Khanh Lam, MD, Emily Walton, BSc, John Petrich, RPh, Roberta C. Palumbo, RN, A. Marc Gillinov, MD, Carolyn Apperson-Hansen, MStat, Eugene H. Blackstone, MD The Journal of Thoracic and Cardiovascular Surgery Volume 131, Issue 4, Pages 853-861.e7 (April 2006) DOI: 10.1016/j.jtcvs.2005.11.018 Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Perioperative magnesium levels. Open circles (placebo group) and filled circles (magnesium group) are mean values within different time intervals. Solid lines are evolution of predicted mean values over time for each group. The Journal of Thoracic and Cardiovascular Surgery 2006 131, 853-861.e7DOI: (10.1016/j.jtcvs.2005.11.018) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Overall and domain scores of the Western Perioperative Neurologic Scale preoperatively and at 24 and 96 hours after extubation in the magnesium (filled circles) and placebo (open circles) groups. Shown are percentages of patients reaching the maximum overall and domain scores (scores indicated on vertical axes). Unadjusted percentages with 68% confidence bars are given for patients with complete scores. A, All 16 neurologic tests. B, Mentation (5 tests). C, Motor (4 tests). D, Sensory function (4 tests). E, Cerebellar function (3 tests). The Journal of Thoracic and Cardiovascular Surgery 2006 131, 853-861.e7DOI: (10.1016/j.jtcvs.2005.11.018) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Estimated percentage of patients with total cerebellar function score of 9 (best possible score) as a function of age. The nomogram represents a solution of the multivariable equation in Table 4 (date of operation set to June 2003). Dashed lines are estimated 68% confidence intervals. The Journal of Thoracic and Cardiovascular Surgery 2006 131, 853-861.e7DOI: (10.1016/j.jtcvs.2005.11.018) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 CONSORT flow chart of patients assessed for eligibility in this randomized trial. The Journal of Thoracic and Cardiovascular Surgery 2006 131, 853-861.e7DOI: (10.1016/j.jtcvs.2005.11.018) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 Unadjusted preoperative and 3-month follow-up neuropsychologic test scores presented for magnesium and placebo groups. Top whisker, Maximum score; bottom whisker, minimum score; top line in box, 85th percentile; middle line, median; bottom line, 15th percentile; +, mean. A, Hopkins Verbal Learning Test (HVLT). B, HVLT delayed recall. C, HVLT discrimination index. D, Controlled Oral Word Association Test (COWAT). E, Boston Naming Test. F, Digit Symbol. G, Symbol Search. H, Grooved Pegboard, dominant hand (D). I, Grooved Pegboard, nondominant hand (ND). J, Trail-Making Test Form A. K, Trail-Making Test Form B. L, Beck Depression Inventory second edition. The Journal of Thoracic and Cardiovascular Surgery 2006 131, 853-861.e7DOI: (10.1016/j.jtcvs.2005.11.018) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions