Prehospital use of magnesium sulfate as neuroprotection in acute stroke.

Study answer

What this study found

Prehospital magnesium sulfate was safe and feasible, but it did not improve 90-day functional outcome after acute stroke. The 90-day global Rankin distribution showed no significant shift versus placebo (P = 0.28), and mean Rankin scores were identical at 2.7 in both groups (P = 1.00). Key secondary outcomes were also neutral, including minimal or no disability (36.5% vs 36.9%; OR 0.98, 0.81-1.20), functional independence (52.4% vs 52.8%; OR 0.98, 0.81-1.19), and death (15.4% vs 15.5%; P = 0.95). Serious adverse events were similar between groups (51.2% vs 50.1%; P = 0.67), with no signal of…

Study & population

Multicenter randomized, placebo-controlled prehospital trial of adults with suspected acute stroke in Los Angeles and Orange Counties, California.

Intervention

Magnesium sulfate was given intravenously as a 4 g bolus in 54 mL normal saline over 15 minutes in the field, followed by 16 g in 240 mL 0.9% normal saline infused at 10 mL/hour for 24 hours.

Key limitation

The trial enrolled patients with suspected stroke before definitive diagnosis, so the population included intracranial hemorrhage and stroke mimics as well as ischemic stroke.

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Original abstract