Open Access Research article

The efficacy of magnesium sulfate loading on microalbuminuria following SIRS: One step forward in dosing

Bahador Mirrahimi1, Hadi Hamishehkar2, Arezo Ahmadi3, Mohamad Reza Mirjalili4, Mostafa Aghamohamadi5, Atabak Najafi6, Mohammad Abdollahi6 and Mojtaba Mojtahedzahed1*

Author Affiliations

1 Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, 1417614411, Iran

2 Department of Clinical Pharmacy, Faculty of Pharmacy, Tabriz University of Medical Science, Tabriz, 1476651664, Iran

3 Department of anesthesia and intensive care, Sina hospital, Tehran University of Medical Science, Tehran, 1136746911, Iran

4 Department of anesthesia and intensive care, Faculty of Medicine, Shahid Sadoghi University of Medical Science, Yazd, 8915173143, Iran

5 Sina hospital, Tehran University of Medical Science, Tehran, 1136746911, Iran

6 Department of Toxicology and Pharmacology, Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, 1417614411, Iran

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DARU Journal of Pharmaceutical Sciences 2012, 20:74  doi:10.1186/2008-2231-20-74

Published: 31 October 2012

Abstract

Backgrounds

Magnesium has been known for its antioxidative and antiinflammatory properties in many studies. In this study two dosing regimens of magnesium were compared with a placebo control group in order to investigate safety and efficacy of high doses of intravenous magnesium sulfate infusion on critically ill trauma patients. Inflammatory and oxidative factors were measured in this trial.

Methods

45 trauma patients with systemic inflammatory response syndromes (SIRS) were randomly assigned into 2 treatment and one placebo groups. The high dose group received 15 g MgSO4, low dose group received 7.5 g of MgSO4 over 4 hour infusion, and placebo group received saline alone. The initial and post magnesium sulfate injections levels of tumor necrosis factor alpha (TNF-α), total antioxidant power and lipid peroxidation were measured after 6, 18 and 36 hours. The pre-infusion along with 6 and 36 hour level of microalbuminuria were also determined.

Results

Repeated measurements illustrated that there was no significant difference in TNF-α, total antioxidant power and lipid peroxidation levels among groups during the period of analysis. The microalbuminuria at 36 hour post infusion of high dose group was lower than that of control group (p = 0.024). Patient’s mortality (28 day) was similar among all treatment groups. Both magnesium infusion groups tolerated the drug without experiencing any complications.

Conclusion

No evidence for antioxidative and antiinflammatory effects of magnesium in traumatic SIRS positive patients was found. Magnesium in high doses may be recommended for traumatic patients with SIRS status to prevent microalbuminuria.

Keywords:
Magnesium; Microalbumin; TNF-α; Oxidative stress; Trauma; Critical care