What is the role of magnesium sulfate in treating sepsis and septic shock?

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Last updated: February 15, 2025 • View editorial policy

From the Research

Role of Magnesium Sulfate in Treating Sepsis and Septic Shock

  • Magnesium sulfate has been used in the intensive care unit (ICU) to correct hypomagnesemia, which is common in critically ill patients 1, 2.
  • Hypomagnesemia has been associated with increased need for mechanical ventilation, prolonged ICU stay, and increased mortality in critically ill patients with sepsis 1.
  • Magnesium sulfate has been shown to have neuroprotective properties and is used as a vasodilator to improve microcirculatory perfusion in patients with sepsis and septic shock 2, 3.
  • However, a study found that magnesium sulfate infusion did not improve microcirculatory perfusion in patients with severe sepsis and septic shock 3.
  • Another study reported the successful use of magnesium sulfate to control life-threatening autonomic hyper-reflexia in a patient with a high spinal cord injury and septic shock 4.
  • A recent retrospective propensity score-matched cohort study found that magnesium sulfate use was associated with lower 28-day all-cause mortality in critically ill patients with sepsis, regardless of baseline serum magnesium status 5.

Mechanisms and Effects

  • Magnesium sulfate has both endothelium-dependent and non-endothelium-dependent vasodilatory pathways, which may help to improve microcirculatory perfusion in patients with sepsis and septic shock 3.
  • Magnesium sulfate may also have a role in reducing the incidence of acute kidney injury in critically ill patients with sepsis 5.
  • The exact mechanisms by which magnesium sulfate exerts its effects in patients with sepsis and septic shock are not fully understood and require further study 1, 5.

Clinical Implications

  • Magnesium sulfate may be a useful adjunctive therapy in the treatment of sepsis and septic shock, particularly in patients with hypomagnesemia 1, 2.
  • Further studies are needed to confirm the findings of the retrospective propensity score-matched cohort study and to determine the optimal dosing and timing of magnesium sulfate administration in patients with sepsis and septic shock 5.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.