The Effect of Magnesium Therapy on Thromboelastographic Findings in Patients with End Stage Liver Disease / 대한마취과학회지

ABSTRACT

BACKGROUND: Patients undergoing liver transplantation may be a group predisposed to hypomagnesemia and bleeding tendency. There is evidence that magnesium is a crucial constituent of the blood coagulation cascade and has a pro-coagulant activity. The purpose of this study was to investigate the effect of magnesium therapy on thromboelastograph (TEG) findings and other clinical parameters in patients undergoing liver transplantation. METHODS: 27 patients scheduled for liver transplantation were included. 1.5 g of magnesium sulfate was diluted in 100 ml of normal saline and infused over a period of 5 minutes to all patients. TEG findings immediately before and after magnesium infusion were compared. Total blood transfused and CaCl2 requirements in these patients were compared with those of a group of patients who received liver transplantation without magnesium therapy. RESULTS: K time and coagulation time (r + k) showed significant reduction, and MA, A60 and TEG index showed significant increases after magnesium therapy (P < 0.05). R time reduced and alpha angle increased after magnesium therapy, but these were not statistically significant. Less blood and CaCl2 was required by these patients (P < 0.05). CONCLUSIONS: Magnesium therapy significantly improved TEG findings of general hypocoagulability in end stage liver disease. It was also associated with a reduced amount of total blood transfused and CaCl2 required during liver transplantation.