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ORIGINAL ARTICLE
Year : 2019  |  Volume : 6  |  Issue : 3  |  Page : 300-305

The effect of magnesium sulfate on cerebral perfusion in patients with sepsis-associated encephalopathy


Critical care medicine department, Faculty of Medicine, Alexandria University, Egypt

Correspondence Address:
Nesreen Shaban
MS Critical Care Medicine Department. 01155550090
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/roaic.roaic_49_18

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Background Sepsis commonly produces brain cognitive dysfunction known as sepsis-associated encephalopathy (SAE). Aim of the study The aim of this study was to assess the effect of administration of an intravenous bolus dose of magnesium sulfate on cerebral perfusion in patients with SAE. Methods Using transcranial Doppler, we measured the mean flow velocity in the middle cerebral artery (cm/sec) and calculated the pulsatility index and resistive index on admission and 30 m after the administration of a 6 g intravenous dose of magnesium sulfate in septic patients with a positive Confusion Assessment Method for the ICU (CAM-ICU) score and Glasgow Coma Scale (GCS) less than 15 during the first 24 h from the onset of sepsis. The measurements were repeated after 24 h and were correlated with the GCS and CAM-ICU score of the patients after 24 h from the onset of sepsis. Results Forty-six sepsis patients without any neurological deficit treated in our 14-bed Critical Care Unit [magnesium group (GroupMg)=23, control group (Groupcontrol)=23] were assessed. No difference was found between the two groups in mean age, mean arterial pressure or Acute Physiology and Chronic Health Evaluation II score. After 24 h, the pulsatility index was significantly reduced in the magnesium group (1.09±0.22, P<0.001) as well as the resistive index (0.62±0.07, P<0.001). Mean flow velocity was significantly higher in the magnesium group after 24 h (49.81±16.24, P<0.001). The magnesium group also displayed a significant improvement in the mean GCS after 24 h (11.65±1.99, P=0.048) and in the CAM-ICU score (negative CAM-ICU=16/23 patients, P≤0.001). Conclusion Our results suggest that the administration of magnesium sulfate during the first 24 h of the onset of sepsis seems to improve cerebral perfusion in patients with SAE and possibly correlates with better neurological outcomes in these patients.


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