Optimal administration dosage of magnesium sulfate for torsades de pointes in children with long QT syndrome.

Abstract

BACKGROUND:

Intravenous administration of magnesium sulphate (MgSO(4)) is a very effective and safe treatment for torsades de pointes (TdP) associated with acquired long QT syndrome (LQTS) in adults. Discussed here is the efficacy of MgSO(4) for TdP in children with congenital and acquired LQTS.

METHODS:

The optimal MgSO(4) dosage and serum magnesium (SMg) was determined in six consecutive children with TdP; four had congenital LQTS and two had acquired LQTS. A bolus injection of MgSO(4) was given intravenously over 1 to 2 minutes followed by continuous infusion for the next 2 to 7 days.

RESULTS:

Of the six patients, five responded completely to the initial bolus of 6.1 +/- 4.2 mg/kg (range, 2.3-12 mg/kg). One (a neonate with congenital LQTS) required a total of 30 mg/kg until complete TdP elimination. Continuous infusion was given at rates of 0.3 to 1.0 mg/kg/hr with no recurrence of TdP. SMg concentration was 3.9 +/- 1.0 mg/dL (2.9-5.4 mg/dL) immediately after bolus injection.

CONCLUSION:

Intravenous MgSO(4) infusion effectively treated TdP in children with LQTS. Optimal bolus dosage, infusion rates and SMg concentration were 3 to 12 mg/kg, 0.5 to 1.0 mg/kg/hr and 3 to 5 mg/dL, respectively.

• Authors: Kenji Hoshino, Kiyoshi Ogawa, Takashi Hishitani, Takeshi Isobe, Yoshikatsu Eto
• Journal: Journal of the American College of Nutrition (J Am Coll Nutr) Vol. 23 Issue 5 Pg. 497S-500S (Oct 2004) ISSN: 0731-5724 [Print] United States
• PMID: 15466950 (Publication Type: Journal Article)

Chemical References

• Anti-Arrhythmia Agents
• Magnesium Sulfate
• Magnesium

Topics

• Anti-Arrhythmia Agents (administration & dosage, therapeutic use)
• Child
• Child, Preschool
• Dose-Response Relationship, Drug
• Electrocardiography
• Humans
• Infant
• Infant, Newborn
• Infusions, Intravenous
• Injections, Intravenous
• Magnesium (blood)
• Magnesium Sulfate (administration & dosage, therapeutic use)
• Male
• Torsades de Pointes (blood, congenital, drug therapy)
• Treatment Outcome