Changes in the plasma electrolyte concentration in the conditions of magnesium therapy in patients with traumatic shock on the background of polytrauma

Authors

  • O.V. Biletskyi Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine

DOI:

https://doi.org/10.22141/2224-0586.5.100.2019.177021

Keywords:

magnesium, magnesium sulfate, water-electrolyte exchange, hypovolemic shock, polytrauma

Abstract

Background. The timing of traumatic shock treatment in patients with polytrauma has a serious impact on the number of complications, the length of stay in the intensive care unit and the cost of treatment. Earlier, it was shown that the use of hypertonic solution of magnesium sulfate helps accelerate the stabilization of hemodynamics in patients with polytrauma. The purpose of the study is to determine the concentration of basic electrolytes in the blood plasma when applying hypertonic magnesium sulfate solution in victims with polytrauma who were in a state of hypovolemic shock. Materials and methods. In 24 patients with polytrauma, who were admitted to the clinic in a state of hypovolemic traumatic shock, correction of hemodynamics with hypertonic solution of magnesium sulfate in normal saline was performed in the operating room. A 25% solution of magnesium sulfate was administered intravenously at a rate of 0.35 ± 0.05 ml/kg body weight in order to create an osmotic gradient between the intravascular and interstitial fluid, as well as to block the flow of sodium and calcium to the intracellular space. When applying this method, changes in the content of blood plasma electrolytes were studied. The concentration of magnesium, potassium, calcium, sodium and chlorides was determined. Blood for the study of electrolyte content has been taken at the following stages: 1) before using hypertonic solution of magnesium sulfate; 2) 5–10 minutes after infusion of magnesium sulfate in normal saline was completed; 3) 25–35 minutes after infusion of magnesium sulfate in normal saline was completed; 4) 1 hour after infusion of magnesium sulfate in normal saline was completed; 5) 2 hours after; 6) 6 hours after; 7) 24 hours after. Results. The study showed that the use of this technique was not associated with a dangerous increase in the concentration of magnesium in the blood plasma to a level of 4.0 mmol/L or more. There was no danger of suppressing cardiac activity. The highest levels of magnesium in the blood plasma were observed at the 2nd stage of the study — 5–10 minutes after infusion of a 25% magnesium sulfate solution in the normal saline was completed. The average concentration of magnesium was 2.15 ± 0.17 mmol/L. Such an increase in blood magnesium level was naturally associated with the inhibition of tendon reflexes and respiratory function. By the end of the study, the magnesium content in the plasma has gradually normalized to 0.98 ± 0.09 mmol/L. Conclusions. The rapid introduction into the body of a high dose of ionized magnesium and sulfate led to temporary reduction in the plasma concentration of other electrolytes according to Gamble’s principle. At certain stages of the study, a significant decrease in the content of potassium, sodium, chlorides in blood plasma was detected. Blood calcium level has changed the least.

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References

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Published

2021-10-01

How to Cite

Biletskyi, O. (2021). Changes in the plasma electrolyte concentration in the conditions of magnesium therapy in patients with traumatic shock on the background of polytrauma. EMERGENCY MEDICINE, (5.100), 69–73. https://doi.org/10.22141/2224-0586.5.100.2019.177021

Issue

Section

Original Researches