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Patients who initially survive aneurysmal subarachnoid hemorrhage (SAH) are at risk for death from delayed cerebral ischemia caused by vasospasm. To determine whether treatment with magnesium sulfate reduces these events, researchers randomized 107 patients with acute SAH who were admitted to a neurosurgical intensive care unit in Germany to receive intravenous magnesium sulfate (bolus of 16 mmol [1920 mg] during 30 minutes followed by continuous infusion of 8 mmol [960 mg] per hour) or placebo. Serum magnesium concentrations were monitored closely and infusions were adjusted to maintain target levels of 2.0–2.5 mmol/L (4–5 mEq/L) for 10 days or until signs of vasospasm resolved. Patients then received tapering oral doses for 12 days.
The in…