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magnesium sulfate neuroprotection

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https://www.readbyqxmd.com/read/28694751/the-role-of-magnesium-sulfate-in-the-intensive-care-unit
#1
REVIEW
Yunes Panahi, Mojtaba Mojtahedzadeh, Atabak Najafi, Mohammad Reza Ghaini, Mohammad Abdollahi, Mohammad Sharifzadeh, Arezoo Ahmadi, Seyyed Mahdi Rajaee, Amirhossein Sahebkar
Magnesium (Mg) has been developed as a drug with various clinical uses. Mg is a key cation in physiological processes, and the homeostasis of this cation is crucial for the normal function of body organs. Magnesium sulfate (MgSO4) is a mineral pharmaceutical preparation of magnesium that is used as a neuroprotective agent. One rationale for the frequent use of MgSO4 in critical care is the high incidence of hypomagnesaemia in intensive care unit (ICU) patients. Correction of hypomagnesaemia along with the neuroprotective properties of MgSO4 has generated a wide application for MgSO4 in ICU...
2017: EXCLI journal
https://www.readbyqxmd.com/read/28589614/optimization-of-maternal-magnesium-sulfate-administration-for-fetal-neuroprotection-application-of-a-prospectively-constructed-pharmacokinetic-model-to-the-beam-cohort
#2
Kathleen F Brookfield, Mohammed Elkomy, Felice Su, David R Drover, Brendan Carvalho
The aim of the study was to identify the optimal therapeutic maternal magnesium drug exposure and maternal serum concentration to prevent cerebral palsy in the extremely preterm fetus. We applied a previously constructed pharmacokinetic model adjusted for indication to a large cohort of pregnant women receiving magnesium sulfate to prevent cerebral palsy in their preterm offspring at 20 different US academic centers between December 1997 and May 2004. We simulated the population-based individual maternal serum magnesium concentration at the time of delivery and the total magnesium dose for each woman who received magnesium sulfate to determine the relationship between maternal serum magnesium level at the time of delivery and the development of cerebral palsy...
June 6, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28583999/paramedic-initiation-of-neuroprotective-agent-infusions-successful-achievement-of-target-blood-levels-and-attained-level-effect-on-clinical-outcomes-in-the-fast-mag-pivotal-trial-field-administration-of-stroke-therapy-magnesium
#3
RANDOMIZED CONTROLLED TRIAL
Kristina Shkirkova, Sidney Starkman, Nerses Sanossian, Marc Eckstein, Samuel Stratton, Frank Pratt, Robin Conwit, Scott Hamilton, Latisha Sharma, David Liebeskind, Lucas Restrepo, Miguel Valdes-Sueiras, Jeffrey L Saver
BACKGROUND AND PURPOSE: Paramedic use of fixed-size lumen, gravity-controlled tubing to initiate intravenous infusions in the field may allow rapid start of neuroprotective therapy for acute stroke. In a large, multicenter trial, we evaluated its efficacy in attaining target serum levels of candidate neuroprotective agent magnesium sulfate and the relation of achieved magnesium levels to outcome. METHODS: The FAST-MAG phase 3 trial (Field Administration of Stroke Therapy - Magnesium) randomized 1700 patients within 2 hours of onset to paramedic-initiated, a 15-minute loading intravenous infusion of magnesium or placebo followed by a 24-hour maintenance dose...
July 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28521581/association-between-the-use-of-magnesium-sulfate-as-neuroprotector-in-prematurity-and-the-neonatal-hemodynamic-effects
#4
Rodrigo Dias Nunes, Flávia Duarte Schutz, Jefferson Luiz Traebert
PURPOSE: Cerebral palsy is often associated with prematurity and magnesium sulfate (MgSO4) has been used as a neuroprotector, with favorable results. However, its mechanism of action has not been fully elucidated. This study aimed to evaluate the association between MgSO4 at the imminent premature delivery and neonatal hemodynamic effects. MATERIALS AND METHODS: A cross-sectional study involving 94 newborns (NB) between 24 and 32 weeks at a Brazilian hospital was performed...
June 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28412496/magnesium-sulfate-mg-prevents-maternal-inflammation-induced-offspring-cerebral-injury-evident-on-mri-but-not-via-il-1%C3%AE
#5
Yuval Ginsberg, Nizar Khatib, Boaz Weiss, Shay Arison, Michael G Ross, Zeev Weiner, Ron Beloosesky
OBJECTIVE: As maternal treatment with magnesium sulfate (MG) may protect the fetal brain, we sought to assess the inflammation associated neuroprotective potential of MG and its association to interleukin 1β (IL-1β). METHODS: Pregnant Sprague-Dawley rats at 18-day gestation received i.p. lipopolysaccharide (LPS) or saline. Dams were randomized to treatment with s.c. saline (control), or MG prior to or following the i.p. injection, resulting in three groups. At the end of the treatment, fetal brain IL-1β was quantified for 18 pregnant rats (six of each group)...
April 12, 2017: Neuroscience
https://www.readbyqxmd.com/read/28395549/magnesium-sulfate-for-neuroprotection-in-the-setting-of-chorioamnionitis
#6
James M Edwards, Laura E Edwards, Geeta K Swamy, Chad A Grotegut
PURPOSE: We examined the effects of magnesium on premature neonatal outcomes complicated by chorioamnionitis. MATERIALS AND METHODS: We conducted a secondary analysis of data from the BEAM Trial, an RCT to determine if antenatal magnesium decreases the incidence of CP in preterm birth. We compared the effect of magnesium sulfate by the presence or absence of chorioamnionitis. Outcomes examined include CP, IVH, NEC, BPD, and assessments of mental and motor disability...
April 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28391733/antenatal-magnesium-sulfate-for-both-tocolysis-and-fetal-neuroprotection-in-premature-rupture-of-the-membranes-before-32-weeks-gestation
#7
Eun Jung Jung, Jung Mi Byun, Young Nam Kim, Kyung Bok Lee, Moon Su Sung, Ki Tae Kim, Jong Beom Shin, Dae Hoon Jeong
OBJECTIVE: We aimed to assess the impact of antenatal MgSO4 therapy given to women with PPROM before 32 weeks' gestation on latency, maternal outcomes, perinatal outcomes, and neurodevelopmental outcomes. METHODS: We undertook a retrospective cohort observational study of 184 singleton pregnancies complicated by PPROM at 23°-31(6) weeks who were hospitalized and received magnesium therapy for tocolysis (MgSO4 group) or did not receive tocolytic therapy (no MgSO4 group) between 2005 and 2013...
April 26, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28318214/preterm-labor-prevention-and-management
#8
Kristen Rundell, Bethany Panchal
In the United States, preterm delivery is the leading cause of neonatal morbidity and is the most common reason for hospitalization during pregnancy. The rate of preterm delivery (before 37 weeks' gestation) has been declining since 2007. Clinical diagnosis of preterm labor is made if there are regular contractions and concomitant cervical change. Less than 10% of women with a clinical diagnosis of preterm labor will deliver within seven days of initial presentation. Women with a history of spontaneous preterm delivery are 1...
March 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28166926/-neuroprotection-for-preterm-infants-with-antenatal-magnesium-sulphate
#9
REVIEW
S Marret, P-Y Ancel
OBJECTIVE: To evaluate in preterm born children the neuroprotective benefits and the risks, at short- and long-term outcome, of the antenatal administration of magnesium sulphate (MgSO4) in women at imminent risk of preterm delivery. MATERIAL AND METHODS: Computer databases Medline, the Cochrane Library and the recommendations of various international scientific societies. RESULTS: Given the demonstrated benefit of antenatal MgSO4 intravenous administration on the reduction of cerebral palsy rates and the improvement of motor development in children born preterm, it is recommended for all women whose imminent delivery is expected or programmed before 32 weeks of gestation (WG) (grade A)...
December 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28132012/use-of-magnesium-sulfate-before-32%C3%A2-weeks-of-gestation-a-european-population-based-cohort-study
#10
H T Wolf, L Huusom, T Weber, A Piedvache, S Schmidt, M Norman, J Zeitlin
OBJECTIVES: The use of magnesium sulfate (MgSO4) in European obstetric units is unknown. We aimed to describe reported policies and actual use of MgSO4 in women delivering before 32 weeks of gestation by indication. METHODS: We used data from the European Perinatal Intensive Care in Europe (EPICE) population-based cohort study of births before 32 weeks of gestation in 19 regions in 11 European countries. Data were collected from April 2011 to September 2012 from medical records and questionnaires...
January 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28056569/maternal-side-effects-fetal-neuroprotection-according-to-body-mass-index-after-magnesium-sulfate-in-a-multicenter-randomized-controlled-trial
#11
Gustavo Vilchez, Jing Dai, Moraima Lagos, Robert J Sokol
OBJECTIVE: Evidence supports the need of dose-adjustment of several drugs according to body mass index (BMI) to prevent toxicity in the underweight, and ensure efficacy in obese women. However, for MgSO4 neuroprotection, the effect of BMI on maternal toxicity and fetal neuroprotection is understudied. We analyze the effect of BMI on maternal/infant outcomes after MgSO4. METHODS: Secondary analysis of a clinical trial that studied MgSO4 neuroprotection. Maternal side effects, magnesium cord levels, and offspring cerebral palsy/death were analyzed along BMI strata using ANOVA and chi-square test...
January 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28008305/magnesium-sulfate-prevents-placental-ischemia-induced-increases-in-brain-water-content-and-cerebrospinal-fluid-cytokines-in-pregnant-rats
#12
Linda W Zhang, Junie P Warrington
Magnesium sulfate (MgSO4) is the most widely used therapy in the clinic to prevent the progression of preeclampsia, a hypertensive disorder of pregnancy, to eclampsia. Eclampsia, manifested as unexplained seizures and/or coma during pregnancy or postpartum, accounts for ~13% of maternal deaths worldwide. While MgSO4 continues to be used in the clinic, the mechanisms by which it exerts its protective actions are not well understood. In this study, we tested the hypothesis that MgSO4 protects against placental ischemia-induced increases in brain water content and cerebrospinal fluid cytokines...
2016: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/27878553/magnesium-sulfate-provides-neuroprotection-in-eclampsia-like-seizure-model-by-ameliorating-neuroinflammation-and-brain-edema
#13
Xiaolan Li, Xinjia Han, Jinying Yang, Junjie Bao, Xiaodan Di, Guozheng Zhang, Huishu Liu
Eclampsia is a hypertensive disorder of pregnancy that is defined by the new onset of grand mal seizures on the basis of preeclampsia and a leading cause of maternal and fetal mortality worldwide. Presently, magnesium sulfate (MgSO4) is the most effective treatment, but the mechanism by which MgSO4 prevents eclampsia has yet to be fully elucidated. We previously showed that systemic inflammation decreases the seizure threshold in a rat eclampsia-like model, and MgSO4 treatment can decrease systemic inflammation...
November 22, 2016: Molecular Neurobiology
https://www.readbyqxmd.com/read/27764015/progesterone-as-a-tocolytic-agent-for-preterm-labor-a-systematic-review
#14
Reshama Navathe, Vincenzo Berghella
PURPOSE OF REVIEW: Tocolytic agents have been used for over 60 years in the fight against preterm labor, which ultimately can lead to preterm birth. Currently, clinicians can choose from a variety of drug classes to achieve the primary goal of delaying delivery by 48 h, thereby allowing time for administration of corticosteroids for fetal lung maturity, and if appropriate, starting magnesium sulfate for fetal neuroprotection. However, there are currently no known therapies to maintain the tocolytic effect beyond those initial 48 h...
December 2016: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27606053/perinatal-neuroprotection-update
#15
REVIEW
Angie C Jelin, Kirsten Salmeen, Dawn Gano, Irina Burd, Mari-Paule Thiet
Antepartum, intrapartum, and neonatal events can result in a spectrum of long-term neurological sequelae, including cerebral palsy, cognitive delay, schizophrenia, and autism spectrum disorders [1]. Advances in obstetrical and neonatal care have led to survival at earlier gestational ages and consequently increasing numbers of periviable infants who are at significant risk for long-term neurological deficits. Therefore, efforts to decrease and prevent cerebral insults attempt not only to decrease preterm delivery but also to improve neurological outcomes in infants delivered preterm...
2016: F1000Research
https://www.readbyqxmd.com/read/27578415/neuroprotective-effects-of-antenatal-magnesium-sulfate-under-inflammatory-conditions-in-a-sprague-dawley-pregnant-rat-model
#16
Audrey Binette, Simon Blouin, Amélie Ardilouze, Jean-Charles Pasquier
OBJECTIVE: Antenatal magnesium sulfate (MgSO4) is recommended for fetal neuroprotection. The aim of this animal study was to assess the neuroprotective effect of in utero exposure to MgSO4, under inflammatory conditions. METHODS: Timed pregnant Sprague-Dawley (SD) rats (n = 29) received four intra-peritoneal (IP) injections of lipopolysaccharides (LPS; 200 μg/kg), combined with increasing concentrations of MgSO4 (25, 50 or 100 mg/kg, n = 19) or saline solution (SS; n = 10)...
August 31, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27569124/observations-of-fetal-brain-activity-via-non-invasive-magnetoencephalography-following-administration-of-magnesium-sulfate-for-neuroprotection-in-preterm-labor
#17
Diana I Escalona-Vargas, Andrew S Thagard, Kaitlin McGrail, Peter G Napolitano, Everett F Magann, Curtis L Lowery, Hari Eswaran
No abstract text is available yet for this article.
October 2016: Prenatal Diagnosis
https://www.readbyqxmd.com/read/27453378/antenatal-exposure-to-magnesium-sulfate-is-associated-with-reduced-cerebellar-hemorrhage-in-preterm-newborns
#18
Dawn Gano, Mai-Lan Ho, John Colin Partridge, Hannah C Glass, Duan Xu, A James Barkovich, Donna M Ferriero
OBJECTIVE: To determine the association of antenatal magnesium sulfate with cerebellar hemorrhage in a prospective cohort of premature newborns evaluated by magnetic resonance imaging (MRI). STUDY DESIGN: Cross-sectional analysis of baseline characteristics from a prospective cohort of preterm newborns (<33 weeks gestation) evaluated with 3T-MRI shortly after birth. Exclusion criteria were clinical evidence of a congenital syndrome, congenital infection, or clinical status too unstable for transport to MRI...
November 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27325362/novel-treatments-in-neuroprotection-for-aneurysmal-subarachnoid-hemorrhage
#19
REVIEW
Robert F James, Daniel R Kramer, Zaid S Aljuboori, Gunjan Parikh, Shawn W Adams, Jessica C Eaton, Hussam Abou Al-Shaar, Neeraj Badjatia, William J Mack, J Marc Simard
New neuroprotective treatments aimed at preventing or minimizing "delayed brain injury" are attractive areas of investigation and hold the potential to have substantial beneficial effects on aneurysmal subarachnoid hemorrhage (aSAH) survivors. The underlying mechanisms for this "delayed brain injury" are multi-factorial and not fully understood. The most ideal treatment strategies would have the potential for a pleotropic effect positively modulating multiple implicated pathophysiological mechanisms at once...
August 2016: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/27317658/magnesium-sulfate-reduces-eeg-activity-but-is-not-neuroprotective-after-asphyxia-in-preterm-fetal-sheep
#20
Robert Galinsky, Vittoria Draghi, Guido Wassink, Joanne O Davidson, Paul P Drury, Christopher A Lear, Alistair J Gunn, Laura Bennet
Magnesium sulfate is now widely recommended for neuroprotection for preterm birth; however, this has been controversial because there is little evidence that magnesium sulfate is neuroprotective. Preterm fetal sheep (104 days gestation; term is 147 days) were randomly assigned to receive sham occlusion (n = 7), i.v. magnesium sulfate (n = 10) or saline (n = 8) starting 24 h before asphyxia until 24 h after asphyxia. Sheep were killed 72 h after asphyxia. Magnesium sulfate infusion reduced electroencephalograph power and fetal movements before asphyxia...
April 2017: Journal of Cerebral Blood Flow and Metabolism
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