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Journal of the American College of Nutrition, Vol. 23, No. 5, 497S-500S (2004)
Published by the American College of Nutrition

Optimal Administration Dosage of Magnesium Sulfate for Torsades de Pointes in Children with Long QT Syndrome

Kenji Hoshino, MD, Kiyoshi Ogawa, MD, Takashi Hishitani, MD, Takeshi Isobe, MD and Yoshikatsu Eto, MD

Department of Pediatric Cardiology, Saitama Children’s Medical Center, Iwatsuki City, Saitama (K.H., K.O., T.H.), JAPAN
Department of Pediatrics, Ibaraki Children’s Hospital, Mito City, Ibaraki (T.I.), JAPAN
Department of Pediatrics, Jikei University School of Medicine, Tokyo (Y.E.), JAPAN

Address reprint requests to: Kenji Hoshino, MD, Pediatric Cardiology, Saitama Children’s Medical Center, 2100 Magome, Iwatsuki City, Saitama 339-8551, JAPAN. E-mail: a0182608{at}pref.saitama.jp

Background: Intravenous administration of magnesium sulphate (MgSO4) is a very effective and safe treatment for torsades de pointes (TdP) associated with acquired long QT syndrome (LQTS) in adults. Discussed here is the efficacy of MgSO4 for TdP in children with congenital and acquired LQTS.

Methods: The optimal MgSO4 dosage and serum magnesium (SMg) was determined in six consecutive children with TdP; four had congenital LQTS and two had acquired LQTS. A bolus injection of MgSO4 was given intravenously over 1 to 2 minutes followed by continuous infusion for the next 2 to 7 days.

Results: Of the six patients, five responded completely to the initial bolus of 6.1 ± 4.2 mg/kg (range, 2.3–12 mg/kg). One (a neonate with congenital LQTS) required a total of 30 mg/kg until complete TdP elimination. Continuous infusion was given at rates of 0.3 to 1.0 mg/kg/hr with no recurrence of TdP. SMg concentration was 3.9 ± 1.0 mg/dL (2.9–5.4 mg/dL) immediately after bolus injection.

Conclusion: Intravenous MgSO4 infusion effectively treated TdP in children with LQTS. Optimal bolus dosage, infusion rates and SMg concentration were 3 to 12 mg/kg, 0.5 to 1.0 mg/kg/hr and 3 to 5 mg/dL, respectively.

Key words: magnesium, torsades de pointes, long QT syndrome, children






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Copyright © 2004 by the American College of Nutrition.