Magnesium Not Recommended After Subarachnoid Bleed
(HealthDay News) – For patients with aneurysmal subarachnoid hemorrhage, intravenous magnesium sulfate is no better than placebo for reduction of poor outcome.
Sanne M. Dorhout Mees, MD, from the Utrecht Stroke Center in the Netherlands, and colleagues conducted a Phase 3 trial in which adult patients with an aneurysmal subarachnoid hemorrhage, who were admitted to hospital within four days of hemorrhage, were randomly allocated to receive 64mmol/day intravenous magnesium sulfate (606 patients) or placebo (597 patients). The primary end point was poor outcome at three months after hemorrhage (score of 4–5 on the modified Rankin Scale) or death.
The researchers found that 26.2%of patients in the magnesium group and 25.3% in the placebo group had poor outcome (risk ratio [RR], 1.03; 95% confidence interval [CI], 0.85–1.25). In an updated meta-analysis of seven randomized trials involving 2,047 patients, magnesium treatment after aneurysmal subarachnoid hemorrhage was not superior to placebo for reducing poor outcome (RR, 0.96; 95% CI, 0.86–1.08).
"Intravenous magnesium sulfate does not improve clinical outcome after aneurysmal subarachnoid hemorrhage, therefore routine administration of magnesium cannot be recommended," the authors conclude.