Analysis of hypo‐ and hypermagnesemia in an intensive care unit cohort

Broman, Marcus; Hansson, Fredrik; Klarin, Bengt

doi:10.1111/aas.13061

Cited by 25 publications

(25 citation statements)

References 19 publications

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“…Hypermagnesemia is defined as a serum Mg level of > 2.2 mg/dL. This entity is very rare; however, it can occur iatrogenically when intravenous MgSO 4 is being administered in patients with chronic renal disease or in those who chronically ingest Mg-containing laxatives [48,49].…”

Section: Hypermagnesemiamentioning

confidence: 99%

“…The clinical manifestations of hypermagnesemia include oliguria (2.5%), loss of patellar reflex (1.6%), cardiac conduction disturbance, respiratory depression, and cardiorespiratory arrest [52]. However, certain studies suggest that hypermagnesemia is associated with an increased need for vasopressor drugs, increased risk of respiratory failure, and increased mortality [48][49][50][51][52].…”

Section: Hypermagnesemiamentioning

confidence: 99%

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Basic considerations on magnesium in the management of neurocritical patients

et al. 2021

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Magnesium is an essential chemical element in human life. In the brain, it is physiologically responsible for a large number of processes involved in intracellular homeostasis, blood-brain barrier integrity, protein synthesis, neuronal proliferation, aging, and apoptosis. Considering that neurocritical care is a relatively new discipline in certain regions of the world and is an independent protective factor of neurological diseases in critical care, it is essential to disseminate basic concepts and utilities of tools that can positively impact the neurological disease burden. Magnesium and its use in neurocritical care are poorly understood. Therefore, this study aimed to review basic concepts regarding the physiology of magnesium in neurological dynamics, its role in the pathophysiology of neurological disorders, and the outcome of its use in the management of neurocritical illnesses.

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Section: Hypermagnesemiamentioning

confidence: 99%

Section: Hypermagnesemiamentioning

confidence: 99%

Basic considerations on magnesium in the management of neurocritical patients

et al. 2021

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“…Hypermagnesemia is uncommon in the normal population given the ability of the kidneys to remove the excess of Mg. The presence of hypermagnesemia has been associated with higher mortality in hospitalized [ 79 ], emergency [ 80 ], intensive care [ 81 , 82 ] and cardiac [ 83 , 84 ] patients.…”

Section: Hypermagnesemia and Mortalitymentioning

confidence: 99%

Magnesium Replacement to Protect Cardiovascular and Kidney Damage? Lack of Prospective Clinical Trials

Muñoz‐Castañeda

Mier

Rodríguez

et al. 2018

IJMS

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Patients with advanced chronic kidney disease exhibit an increase in cardiovascular mortality. Recent works have shown that low levels of magnesium are associated with increased cardiovascular and all-cause mortality in hemodialysis patients. Epidemiological studies suggest an influence of low levels of magnesium on the occurrence of cardiovascular disease, which is also observed in the normal population. Magnesium is involved in critical cellular events such as apoptosis and oxidative stress. It also participates in a number of enzymatic reactions. In animal models of uremia, dietary supplementation of magnesium reduces vascular calcifications and mortality; in vitro, an increase of magnesium concentration decreases osteogenic transdifferentiation of vascular smooth muscle cells. Therefore, it may be appropriate to evaluate whether magnesium replacement should be administered in an attempt to reduce vascular damage and mortality in the uremic population In the present manuscript, we will review the magnesium homeostasis, the involvement of magnesium in enzymatic reactions, apoptosis and oxidative stress and the clinical association between magnesium and cardiovascular disease in the general population and in the context of chronic kidney disease. We will also analyze the role of magnesium on kidney function. Finally, the experimental evidence of the beneficial effects of magnesium replacement in chronic kidney disease will be thoroughly described.

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“…In the general ICU at Rigshospitalet in Copenhagen, Denmark, the procedure is to measure magnesium, phosphate and zinc levels twice weekly. During a literature search, we found large variation in practice amongst Swedish and Dutch ICUs 11‐13 …”

Section: Introductionmentioning

confidence: 99%

Preferences for the measurement and supplementation of magnesium, phosphate and zinc in ICUs: The international WhyTrace survey

Vesterlund

Ostermann

Myatra

et al. 2020

Acta Anaesthesiol Scand

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Background Patients admitted to the Intensive Care Unit (ICU) often have low magnesium, phosphate and zinc levels. Monitoring of serum concentrations and supplementation may be important, but there is no consensus on optimal practice. The objective of the WhyTrace survey was to describe current practice regarding the measurement and supplementation of magnesium, phosphate and zinc in ICUs. Methods A 54‐item electronic questionnaire was developed in accordance with SURGE, SUrvey Reporting GuidelinE, to address international clinical practice in the ICU. National investigators recruited ICUs in ten countries with one physician responding per ICU using a unique e‐mail distributed survey‐link. Results The questionnaire was sent to clinicians in 336 ICUs of whom 283 (84%) responded. In 62% of the ICUs, a standard procedure was in place regarding the measurement of serum magnesium levels, in 58% for phosphate and in 9% for zinc. Zinc was never or rarely measured in 64% of ICUs. The frequency of requesting serum levels varied from twice daily to once weekly. Regarding supplementation, 66% of ICUs had a standard procedure for magnesium, 63% for phosphate and 15% for zinc. Most procedures recommended supplementation when serum levels were below the lower reference level, but some used the upper reference levels as the threshold for supplementation and others decided on a case‐by‐case basis. Conclusion The practice of measuring and supplementing magnesium, phosphate and zinc differed substantially between ICUs. Our findings indicate that there is a need for high‐quality prospective data on frequencies of measurements, treatment goals and effects of supplementation on patient‐important outcomes.

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Analysis of hypo‐ and hypermagnesemia in an intensive care unit cohort

Abstract: Patients with magnesium deviations are more ill compared to patients with explicitly normal magnesium values throughout the ICU stay. Cox analysis suggests that the magnesium deviation itself might have an impact on mortality.

Cited by 25 publications

References 19 publications

Basic considerations on magnesium in the management of neurocritical patients

Basic considerations on magnesium in the management of neurocritical patients

Magnesium Replacement to Protect Cardiovascular and Kidney Damage? Lack of Prospective Clinical Trials

Preferences for the measurement and supplementation of magnesium, phosphate and zinc in ICUs: The international WhyTrace survey

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