A Healthy Dose of Heavy Metal: Magnesium and Acute Lung Injury

Abstract

Acute lung injury (ALI) and its more serious manifestation, acute respiratory distress syndrome (ARDS), are all too common occurrences in intensive care units around the world that create a large debt to society both in the short term [ 1 Rubenfeld G.D. Caldwell E. Peabody E. et al. Incidence and outcomes of acute lung injury. N Engl J Med. 2005; 353: 1685 Crossref PubMed Scopus (2783) Google Scholar ] and the long term [ 2 Herridge M.S. Tansey C.M. Matte A. et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011; 364: 1293 Crossref PubMed Scopus (1671) Google Scholar ]. These clinical syndromes claim thousands of lives each year and have been the object of many high profile studies in the past two decades. Unfortunately, despite extensive research efforts, we still have relatively little we can do to treat this condition. First described in 1967 [ 3 Ashbaugh D.G. Bigelow D.B. Petty T.L. et al. Acute respiratory distress in adults. Lancet. 1967; 2: 319 Abstract PubMed Google Scholar ] with acute dyspnea, hypoxia refractory to oxygen therapy, and diffuse lung infiltrates, the ALI/ARDS definition was further refined in 1994 by the American-European Consensus Conference on ARDS, which is still in use today. ALI requires: (1) acute onset, (2) a ratio of arterial oxygen tension to inspired oxygen concentration (PaO2/FiO2) of less than 300 mm Hg, (3) bilateral infiltrates on chest radiograph, and (4) absence of left ventricular dysfunction [ 4 Bernard G.R. Artigas A. Brigham K.L. et al. The American-European Consensus Conference on ARDSDefinitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 1994; 149: 818 Crossref PubMed Scopus (5235) Google Scholar ]. The definition for ARDS is the same except it requires the PaO2/FiO2 to be less than 200 mm Hg. Magnesium Sulfate Mitigates Lung Injury Induced by Bilateral Lower Limb Ischemia-Reperfusion in RatsJournal of Surgical ResearchVol. 171Issue 1PreviewLower limb ischemia-reperfusion (I/R) elicits oxidative stress and causes inflammation in lung tissues that may lead to lung injury. Magnesium sulfate (MgSO4) possesses potent anti-oxidation and anti-inflammation capacity. We sought to elucidate whether MgSO4 could mitigate I/R-induced lung injury. As MgSO4 is an L-type calcium channel inhibitor, the role of the L-type calcium channels was elucidated. Full-Text PDF