{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T03:28:44Z","timestamp":1778124524605,"version":"3.51.4"},"reference-count":27,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the efficacy, safety, and cost-effectiveness of a perioperative magnesium (Mg) sulfate protocol in reducing postoperative atrial fibrillation (AF) incidence and ICU resource strain following cardiac surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Design: Double-blind, single-center randomized controlled trial (RCT). Setting: Tertiary-care academic hospital. Participants: 130 adults undergoing elective cardiac surgery, randomized to Mg sulfate (n=65) or placebo (n=65). Interventions: The Mg group received a pharmacokinetic-guided regimen: 2 g intravenous bolus post-cardiopulmonary bypass, followed by 1 g\/h infusion for 5 hours, then 200 mg\/h for 19 hours, and oral supplementation (I g every 8 hours) for one week post-discharge. The placebo group received equivalent saline infusions and oral placebo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Primary outcome: AF incidence was 18.5% in the Mg group vs. 41.5% in placebo (unadjusted RR=0.45, 95% CI: 0.25\u20130.81; p=0.007). Secondary outcomes: Mg shortened ICU stay by 1.4 days (p&lt;0.001), reduced mechanical ventilation duration by 3.2 hours (p&lt;0.001), and demonstrated comparable safety profiles for hypotension and renal impairment. Subgroup analysis: CABG patients showed 65% risk reduction (OR=0.35, p=0.01). Cost-effectiveness: ICU stay reduction projected $3,500 savings per patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Perioperative Mg sulfate significantly reduces AF incidence, accelerates recovery, and lowers healthcare costs, supporting its integration into standardized postoperative protocols. This trial provides Level I evidence for Mg as a guideline-recommended intervention. These findings are promising and support the integration of Mg into standardized postoperative protocols; however, they require confirmation in larger, multicenter studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2478\/jccm-2026-0001","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T18:03:24Z","timestamp":1771265004000},"page":"95-101","source":"Crossref","is-referenced-by-count":2,"title":["Pharmacokinetic-guided magnesium prophylaxis in cardiac surgery: A randomized trial demonstrating guideline-level reductions in atrial fibrillation, accelerated recovery, and systemic cost savings"],"prefix":"10.2478","volume":"12","author":[{"given":"Sarah Hamdy","family":"Elghareeb","sequence":"first","affiliation":[{"name":"Ain Shams University Faculty of Medicine , Cairo , Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Islam","family":"Taher","sequence":"additional","affiliation":[{"name":"Ain Shams University Faculty of Medicine , Cairo , Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Abd Al Ghany","sequence":"additional","affiliation":[{"name":"Ain Shams University Faculty of Medicine , Cairo , Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noha Mohamed","family":"Abdelaziz","sequence":"additional","affiliation":[{"name":"Ain Shams University Faculty of Medicine , Cairo , Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"key":"2026021618184852035_j_jccm-2026-0001_ref_001","doi-asserted-by":"crossref","unstructured":"Fuller JA, Adams GG, Buxton B. 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