Magnesium sulfate (MgSO4) treatment is evaluated for improving outcomes for patients experiencing aneurysmal subarachnoid hemorrhage (SAH). A literature review was conducted searching databases including Medline, Embase, Scopus, and Cochrane to identify studies comparing intravenous MgSO4 to no MgSO4 treatment on clinical outcomes. The Cochrane review from 2008 on MgSO4 versus placebo in addition to nimodipine was also examined. For a treatment to be considered effective, the National Health and Medical Research Council evidence hierarchy requires at least 6 level II studies or 10 level I systematic reviews, including Cochrane reviews.

1. Magnesium for aneurysmal SHA: panacea or
illusion?
EBS presentation
26/07/2012
David Bervini, Nazih Assaad

2. Searchable question
• “Is i.v. MgSO4 treatment effective in improving the outcome of
patient experiencing aneurysmal SAH?”
• Databases
– Ovid Medline, using MeSH
– Ovid EMBASE, using Emtree
– Scopus using review articles and tracking references
– The Cochrane Collaboration

3. • P Patient with aneurysmal subarachnoid haemorrhage
• I i.v. MgSO4
• C no MgSO4
• O clinical outcome

4. Medline VS EMBASE
Search strategy

13. Cochrane 2008
• MgSO4 VS placebo in addition of nimodipine

16. National Health and Medical Research Council (NHMRC)
Evidence Hierarchy
• At least 6 level II studies
• At least 10 level I reviews (including Cochrane)

17. Conclusion and discussion