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Magnesium Most commonly used to promote conversion to sinus rhythm post-bypass Often given prophylactically to prevent dysrhythmias (typical dose: 2-4 grams) Hypomagnesemia is common post-bypass due to: Administration of Mg-free fluids during bypass Diuresis Has a low side effect profile Calcium Commonly administered to promote ventricular contractility when weaning from bypass Hypocalcemia is common post-bypass, especially due to: Blood transfusions containing citrate (which chelates Ca) Hypothermia-induced coagulopathy req blood products Must be rapidly corrected when weaning from bypass to maintain cardiac contractility Potassium Hypokalemia can occur post-bypass Main cause: Aggressive insulin treatment for hyperglycemia causing intracellular potassium shift Note: While cardioplegia solutions contain high potassium, they don't significantly affect systemic levels when weaning May need repletion to prevent increased automaticity and arrhythmias Phosphorus Levels may be depleted post-bypass, especially with blood transfusions Calcium citrate from transfusions can chelate free phosphorus Hypophosphatemia associated with: Prolonged ventilation time Greater postoperative vasopressor requirements Extended hospital stays