Association between ionized magnesium and postoperative shivering

Nakayama, T.; Umehara, Kaoru; Shirozu, Kazuhiro; Sumie, Makoto; Karashima, Yuji; Higashi, Michiyo; Yamaura, Ken

doi:10.1007/s00540-021-02914-y

Cited by 3 publications

(4 citation statements)

References 28 publications

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“…There was no significant difference in the serum magnesium concentration between patients that were operated on and those that had massive RBCs transfusion administered because of other reasons. This is contrary to the observations of other researchers, who reported a decrease in serum magnesium concentrations after surgeries [8,15].…”

Section: Discussioncontrasting

confidence: 99%

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Massive Transfusion Increases Serum Magnesium Concentration

Malinowska,

Małecka-Giełdowska,

Pietrucha

et al. 2023

JCM

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(1) Background: The massive transfusion of packed red blood cells (RBCs) is a lifesaving procedure, but it is associated with complications, e.g., dysmagnesemia. Since magnesium is an intracellular ion, the transfused RBCs can significantly influence the magnesium concentration in the recipient’s blood. (2) Methods: A retrospective study was performed among 49 patients hospitalized in the Central Clinical Hospital of the Medical University of Warsaw who received a massive blood transfusion (≥4 units/h). Data on laboratory results and patient history were collected from the hospital database. The intracellular RBCs magnesium concentration was measured in 231 samples using the colorimetric method. (3) Results: There were statistically significant changes in the mean serum magnesium concentration preoperatively and 24 h postoperatively (0.87 ± 0.13 vs. 1.03 ± 0.14, p < 0.00001) and 48 h postoperatively (0.87 ± 0.13 vs. 1.06 ± 0.15, p < 0.00001). Patients who died had significantly higher serum magnesium concentrations (p < 0.05). The median intracellular magnesium concentration in RBCs was 0.91 (0.55–1.8) mmol/L, which is below the reference values of 1.65–2.65 mmol/L. (4) Conclusions: Transfused RBCs significantly increased the serum magnesium concentration 24 h and 48 h postoperatively. It could be a result of mild hemolysis, as the median intracellular magnesium concentration in RBCs was below the reference values.

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Section: Discussioncontrasting

confidence: 99%

“…Hypomagnesemia is a common electrolyte disturbance occurring after severe events, like cardiac arrests [14]. However, it also seems to be one of the disturbances following surgeries in general and cardiac surgery, after which magnesium levels fall within the first 24 h [15,16].…”

Section: Introductionmentioning

confidence: 99%

Massive Transfusion Increases Serum Magnesium Concentration

Malinowska,

Małecka-Giełdowska,

Pietrucha

et al. 2023

JCM

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“…The current study showed the value of measuring iMg as a direct predictor of POAF. The cut-off value of iMg, 0.46 mmol/L, was consistent with the range of clinical hypo-ionized hypomagnesemia [11], suggesting an indication for magnesium sulfate supplementation. Magnesium supplementation targeting iMg ≥0.50 mmol/L during artificial heart-lung management has been shown to decrease the frequency of ventricular tachycardia and prolong the duration of sinus rhythm in coronary artery bypass surgery [22].…”

Section: Discussionsupporting

confidence: 68%

“…Intraoperative iMg was measured using a blood gas analyzer (Stat pHOx UltraTM, Nova Biomedical, Waltham, MA, USA). The standard value of iMg was set at 0.48-0.60 mmol/L [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

Ionized Hypomagnesemia Is Associated With Increased Incidence of Postoperative Atrial Fibrillation After Esophageal Resection: A Retrospective Study

Hizuka

Kato

Shiko

et al. 2021

Cureus

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Introduction: Postoperative atrial fibrillation (POAF) is common after surgery for esophageal cancer and may prolong hospitalization and elevate mortality. POAF and hypomagnesemia are linked, but this is based on studies showing an association of POAF with serum total magnesium (tMg). In contrast, the relationship of POAF with ionized magnesium (iMg), which has physiological activity, has not been examined. In this study, the association between hypomagnesemia and POAF was investigated retrospectively to examine iMg as a possible predictive factor for POAF. Methods: The subjects were 151 patients who underwent right transthoracoabdominal subtotal esophagectomy at Saitama Medical Center between January 2011 and December 2020. The incidence of POAF and predictive factors were examined retrospectively. Perioperative predictive factors were subjected to univariate analysis, and items with P<0.1 were then included in multivariate analysis, along with five potential POAF predictors reported in the literature (age, gender, body mass index, hypertension, and diabetes mellitus). P<0.05 was regarded as significant in the multivariate analysis. Results: Of the 151 patients, 34 (23%) developed POAF. In univariate analysis, six factors with P<0.1 (oral statin, dyslipidemia, iMg level after anesthesia induction, maximum and minimum iMg during surgery, and iMg level immediately before admission to ICU) were identified. In multivariate analysis including these and the five literature factors as explanatory variables, iMg immediately before admission to ICU emerged as a predictive factor for POAF (iMg≥0.46 mmol/L, OR 0.32, 95%CI 0.14-0.74, p=0.01) (standard iMg range: 0.48-0.60 mmol/L). Conclusion: The iMg level immediately before admission to ICU may be associated with the development of POAF. A further study is needed to evaluate changes in iMg in the ICU and iMg at the time of onset of POAF.

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