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.