Skip to main content
    • Aa
    • Aa

Effects of calcium and magnesium pretreatment on hyperkalaemic cardiac arrest in rats

  • M. W. Hollmann (a1) (a2), D. Strümper (a3) (a4), V. A. Salmons (a1) (a5), J. M. Washington (a1) and M. E. Durieux (a1) (a3)...


Background and objective: Administration of calcium safely and effectively reverses many of the electrophysiological actions of hyperkalaemia, but it has not been studied for pretreatment. Based on cellular studies, magnesium also has been suggested to prevent the effects of potassium on the heart. As their mechanisms of action differ, a combination of these drugs might have a synergistic protective action. Both compounds are inexpensive and can be administered safely in modest doses. We investigated whether magnesium, calcium or their combination could protect against hyperkalaemic cardiac arrest.

Methods: Twenty-four adult rats were anaesthetized with halothane and randomly pretreated with CaCl2 15 mg kg−1, MgSO4 30 mg kg−1, CaCl2 7.5 mg kg−1 + MgSO4 15 mg kg−1 or physiological saline. Potassium (0.01 mmol kg−1 h−1) was infused. The times to the first dysrhythmia, mean arterial pressure decrease to <40% of baseline and cardiovascular collapse were measured.

Results: Serum potassium concentrations increased to similar values in all groups (to 12.0 ± 0.2 mmol L−1 at the time of collapse). No differences in survival times were observed between groups. There was a trend for respiratory values to be better in the group receiving magnesium.

Conclusions: Pretreatment with magnesium, calcium or a combination of both did not influence the time to cardiovascular collapse, and is therefore – at least in our model – not of any benefit in preventing hyperkalaemic cardiac arrest.

Corresponding author
Correspondence to: Marcel Durieux, Department of Anesthesiology, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands. E-mail:; Tel: +31 43 387 7457; Fax: +31 43 387 5457
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

ThapaS, BrullSJ. Succinylcholine-induced hyperkalemia in patients with renal failure: an old question revisited.Anesth Analg2000; 91: 237241.

MacLennanN, HeimbachDM, CullenBF. Anesthesia for major thermal injury.Anesthesiology1998; 89: 749770.

GronertGA, TheyeRA. Pathophysiology of hyperkalemia induced by succinylcholine.Anesthesiology1975; 43: 8999.

KraftLF, KatholiRE, WoodsWT, JamesTN. Attenuation by magnesium of the electrophysiologic effects of hyperkalemia on human and canine heart cells.Am J Cardiol1980; 45: 11891195.

IfuneCK, SteinbachJH. Voltage-dependent block by magnesium of neuronal nicotinic acetylcholine receptor channels in rat phaeochromocytoma cells.J Physiol1991; 443: 683701.

LevinskyNG. Management of emergencies. VI. Hyperkalemia. N Engl J Med1966; 274: 10761077.

AckerCG, JohnsonJP, PalevskyPM, GreenbergA. Hyperkalemia in hospitalized patients: causes, adequacy of treatment, and results of an attempt to improve physician compliance with published therapy guidelines.Arch Intern Med1998; 158: 917924.

NugentM, TinkerJH, MoyerTP. Verapamil worsens rate of development and hemodynamic effects of acute hyperkalemia in halothane-anesthetized dogs: effects of calcium therapy.Anesthesiology1984; 60: 435439.

KunisCL, LowensteinJ. The emergency treatment of hyperkalemia.Med Clin North Am1981; 65: 165176.

GomezMN. Magnesium and cardiovascular disease.Anesthesiology1998; 89: 222240.

RochesterDF, AroraNS. Respiratory muscle failure.Med Clin North Am1983; 67: 573597.

JohnsonD, GallagherC, CavanaughM, YipR, MayersI. The lack of effect of routine magnesium administration on respiratory function in mechanically ventilated patients.Chest1993; 104: 536541.

GluckmanTJ, CorbridgeT. Management of respiratory failure in patients with asthma.Curr Opin Pulm Med2000; 6: 7985.

MangatHS, D'SouzaGA, JacobMS. Nebulized magnesium sulphate versus nebulized salbutamol in acute bronchial asthma: a clinical trial.Eur Respir J1998; 12: 341344.

MillsR, LeadbeaterM, RavaliaA. Intravenous magnesium sulphate in the management of refractory bronchospasm in a ventilated asthmatic.Anaesthesia1997; 52: 782785.

DowneyP, CoxR. Update on the management of status asthmaticus.Curr Opin Pediatr1996; 8: 226233.

SydowM, CrozierTA, ZielmannS, RadkeJ, BurchadiH. High-dose intravenous magnesium sulfate in the management of life-threatening status asthmaticus.Intensive Care Med1993; 19: 467471.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

European Journal of Anaesthesiology
  • ISSN: 0265-0215
  • EISSN: 1365-2346
  • URL: /core/journals/european-journal-of-anaesthesiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Abstract views

Total abstract views: 89 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 22nd September 2017. This data will be updated every 24 hours.