Magnesium for acute traumatic brain injury.

BACKGROUND: Acute traumatic brain injury is a leading cause of death and disability in young adults. Magnesium had been considered as a potential therapeutic tool because of its activity on NMDA-receptors, calcium channels and neuron membranes. Animals studies have indicated a beneficial effect of magnesium on outcome after brain injury, but its efficacy in humans is unknown.

OBJECTIVES: To quantify the effect of magnesium administration on mortality and morbidity in patients with acute traumatic brain injury.

SEARCH STRATEGY: We searched the Cochrane Injuries Group's specialised register, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, National Research Register, Current Controlled Trials, SIGLE, LILACS, Zetoc. The searches were conducted in July 2005.

SELECTION CRITERIA: We included all randomized controlled trials comparing any magnesium salt with no magnesium or with placebo, in patients following acute traumatic brain injury.

DATA COLLECTION AND ANALYSIS: Two authors independently screened search results and assessed the full texts of potentially relevant studies for inclusion. Data were extracted and methodological quality was examined.

MAIN RESULTS: Three studies met the inclusion criteria, one of which is an ongoing study. Two studies were included in the analysis. No data on mortality were available. For Glasgow Outcome Score at six months the pooled WMD = 0.55 (95% CI -0.15 to 1.26), P = 0.12.

AUTHORS' CONCLUSIONS: There is currently no evidence to support the use of magnesium salts in patients with acute traumatic brain injury.