Use of magnesium sulfate to accelerate the withdrawal of patients suffering from hypovolemic traumatic shock in a resuscitation room and operating room

Abstract

Summary. The study presents the justification for the use of magnesium sulfate when providing emergency medical care to patients in a state of hypovolemic traumatic shock. In order to increase the efficiency of fluid resuscitation and to prevent membrane cell damage caused by ischemia / reperfusion, a solution of magnesium sulfate in a normal saline is used. The concentration of magnesium ions in the solution proposed is entirely consistent with the physiological content of magnesium ions in the blood plasma.The study included 48 patients who arrived at the intensive care unit, and subsequently into the surgical unit, in a state of traumatic shock. For patients in the control group (n = 24), fluid resuscitation was performed according to the protocol “Hypovolemic shock” of the Ministry of Health of Ukraine (2014). Patients in the main group (n=24) also received infusion of magnesium sulfate at a concentration of 0.95 mMol / L. The indicators of central, peripheral hemodynamics (perfusion index), oxygen capillary blood saturation and carboxylated hemoglobin content in blood were stated.Patients in the main group had significantly better indicators of central hemodynamics, volume peripheral capillary perfusion and capillary blood oxygen saturation in 4 stages of the study, compared with patients treated strictly by protocol. The use of magnesium sulfate was associated with a significantly lower endogenous production in the body of patients with carbon monoxide. This effect may be due to prevention of cell membrane damage during reperfusion by blocking ionic calcium channels and limiting the activity of free radical reactions.