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High-dose IV magnesium in mesothelioma patients receiving surgery with hyperthermic intraoperative cisplatin: Pilot studies and design of a phase II randomized clinical trial.
- Source :
-
Journal of surgical oncology [J Surg Oncol] 2023 Dec; Vol. 128 (7), pp. 1141-1149. Date of Electronic Publication: 2023 Sep 13. - Publication Year :
- 2023
-
Abstract
- Introduction: Hyperthermic intraoperative cisplatin (HIOC) is associated with acute kidney injury (AKI). Administration of high-dose magnesium attenuates cisplatin-induced AKI (CP-AKI) in animal models but has not been rigorously examined in humans.<br />Methods: We tested the feasibility and safety of different doses of magnesium in mesothelioma patients receiving HIOC. In Pilot Study 1, we administered a 36-h continuous infusion of magnesium at 0.5 g/h, targeting serum magnesium levels between 3 and 4.8 mg/dL. In Pilot Study 2A, we administered a 6 g bolus followed by an infusion starting at 2 g/h, titrated to achieve levels between 4 and 6 mg/dL. We eliminated the bolus in Pilot Study 2B.<br />Results: In Pilot Study 1, all five patients enrolled completed the study; however, median postoperative Mg levels were only 2.4 mg/dL. In Pilot Study 2A, two of four patients (50%) were withdrawn due to bradycardia during the bolus. In Pilot Study 2B, two patients completed the study whereas two developed postoperative bradycardia attributed to the magnesium.<br />Conclusions: A 0.5 g/h infusion for 36 h did not achieve therapeutic magnesium levels, while an infusion at 2 g/h was associated with bradycardia. These studies informed the design of a randomized clinical trial testing whether intravenously Mg attenuates HIOC-associated AKI.<br /> (© 2023 Wiley Periodicals LLC.)
- Subjects :
- Humans
Cisplatin adverse effects
Pilot Projects
Magnesium therapeutic use
Bradycardia chemically induced
Bradycardia drug therapy
Mesothelioma drug therapy
Mesothelioma, Malignant chemically induced
Mesothelioma, Malignant drug therapy
Acute Kidney Injury chemically induced
Acute Kidney Injury drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1096-9098
- Volume :
- 128
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 37702402
- Full Text :
- https://doi.org/10.1002/jso.27412