Overview
A double-blind, multi-centre, randomized, placebo-controlled, feasibility pilot trial in the prevention of new onset atrial fibrillation of critically ill patients admitted to an ICU.
Description
Most studies of new onset atrial fibrillation (NOAF) in critical illness focus on treatment of this arrhythmia but this innovative study will focus on prevention. Parenteral Mg is a low cost and readily available treatment that may be beneficial for reducing the incidence of NOAF in critically ill patients, with the potential to improve patient centred outcomes and provide a cost effective prophylaxis. The main outcome of this study is to determine if it is feasible to conduct a randomized controlled trial comparing parenteral magnesium sulfate with placebo for the prophylaxis of new onset atrial fibrillation in critically ill patients.
Eligibility
Inclusion Criteria:
- Age ≥18 years
- Admitted to a critical care unit with EITHER:
- Non-invasive ventilation (including high flow nasal canula) or invasive mechanical ventilation with an expected duration >24 hours AND/OR
- Vasopressor or ionotropic support for shock of any etiology. Shock is defined by the need for one of the following vasopressors/inotropes:
Dopamine Dobutamine Norepinephrine Epinephrine Ephedirine Milrinone at any dose (if
used in conjunction with another agent) Vasopressin (if used in conjunction with
another agent)
3. Receiving continuous cardiac monitoring.
Exclusion Criteria:
1. >12 hours from ICU admission
2. Active atrial fibrillation prior to randomization or pre-existing (permanent or
paroxysmal) atrial fibrillation
3. Unlikely to survive >24 hours or palliative patients
4. Cardiac surgery patients
5. Patients requiring parenteral magnesium therapy (e.g. pre-eclampsia, asthma)
6. Transfer from another ICU
7. Patients receiving dialysis
8. Positive pregnancy test
9. Previously enrolled in this trial
10. Treating physician refuses enrollment