Effectiveness and Safety of Magnesium Replacement in Critically Ill Patients Admitted to the Medical Intensive Care Unit in an Academic Medical Center: A Retrospective, Cohort Study

Hammond, Drayton A.; Stojakovic, Jelena; Kathe, Niranjan; Tran, Julie; Clem, Oktawia A; Erbach, Kristina; King, Jarrod B.

doi:10.1177/0885066617720631

Cited by 16 publications

(13 citation statements)

References 8 publications

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“…Consequently, the incidence of hypomagnesaemia was significantly lower in the study group from the second day to the seventh day of the study. This is in accordance with Hammond et al (2017), [43] Kanji and Jung (2009), [35] Owen et al (2008) [40] and Hijazi and Al-Ansari (2005) [13] findings. On the country, Couture et al (2013) [33] did not find difference between the two groups in relation to magnesium replacement.…”

Section: Discussionsupporting

confidence: 90%

Effect of applying nurses driven electrolyte repletion protocol on electrolyte disturbances control among critically ill patients

Abdelgawad

Ahmed

Elmenshawy

2020

JNEP

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Background and objective: Electrolyte disturbances remain a common lifesaving issue in the intensive care units. They are associated with increased morbidity and mortality. They are mostly resulted secondary to critical illness itself or associated treatment modalities. Therefore, electrolytes repletion should be done effectively and timely. This could be ensured using nurse driven protocols rather than traditional methods of repletion. These protocols are nurse initiated and collaboratively developed. They have been shown to improve patient care outcomes through the provision of high quality care. They are increasingly being used in the critical care setting. Objective: Determine the effect of applying nurses driven electrolytes repletion protocol on electrolytes disturbance control among critically ill patients.Methods: Quasi experimental research design was used. Sixty two critically ill patients with electrolytes loss were enrolled in the study at Alexandria Main University Hospital intensive care units, Egypt. All episodes of electrolyte loss were evaluated. Repletion of electrolyte loss was done according to unit routine for the control group and nurses driven electrolytes repletion protocol for the study group. Episodes of electrolyte disturbances, adverse events and timing of repletion were evaluated.Results: Neurological disorders represent the most encountered diagnosis. The most common cause of electrolyte loss in was the use of diuretics. Furthermore, there was a highly statistical difference between the two groups as regard electrolytes levels, effectiveness and timing of replacement.Conclusions: Application of nurses driven electrolyte repletion protocol resulted in improvements in the effectiveness and timeliness of electrolyte replacement.

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Section: Discussionsupporting

confidence: 90%

Effect of applying nurses driven electrolyte repletion protocol on electrolyte disturbances control among critically ill patients

Abdelgawad

Ahmed

Elmenshawy

2020

JNEP

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“…A common rule of thumb for IV magnesium replacement is a serum change range of 0.08 to 0.18 mg/dL per gram administered; therefore, the change expected from 3 to 5 g of IV magnesium would have been 0.2 to 0.9 mg/ dL. 2,3 Unfortunately, various other factors were not reported including renal function, use of enteral or oral nutrition, presence of diarrhea, and insulin or diuretic use that could have affected the primary and secondary outcomes. In addition, the number of patients who received oral magnesium was reported, but the rationale why it was used (over IV replacement or concurrently), dose, and number of days received were not, as this could have contributed to fecal magnesium losses.…”

Section: To the Editormentioning

confidence: 99%

Intravenous Magnesium Replacement in Patients With Hypomagnesemia: Time Is of the Essence

Zhou

Canada

2019

Hosp Pharm

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“…Inadequate replacement of magnesium may have affected attainment of target serum potassium concentrations in our sample; however, achievement of a safe, target magnesium concentration of at least 2 mEq/L may occur less often than previously thought after magnesium replacement. 12 In a cohort of critically ill patients with hypomagnesemia who had magnesium replacement, less than 60% of the patients achieved a serum magnesium concentration of at least 2 mEq/L.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and Safety of Potassium Replacement in Critically Ill Patients: A Retrospective Cohort Study

Hammond

King

Kathe

et al. 2019

Critical Care Nurse

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Background Rules of thumb for potassium replacement are used in intensive care units despite minimal empirical validation. Objective To evaluate the effectiveness and safety of rule-of-thumb potassium replacement in critically ill patients with mild and moderate hypokalemia. Methods A retrospective, observational study was done of patients with mild (potassium, 3-3.9 mEq/L) and moderate (potassium, 2-2.9 mEq/L) hypokalemia admitted to a medical intensive care unit who received potassium replacement. Expected and actual frequencies of replacement that achieved target potassium concentrations (≥ 4 mEq/L) were compared by using a c 2 test. Logistic regression analysis was used to assess whether rule-of-thumb administration affected the probability of target attainment within 24 hours of replacement. Results Serum potassium concentrations were checked within 24 hours after potassium replacement on 354 of 577 days (61.4%) when replacement was provided. Concentrations were within target range in 82 instances (23.2%). Of 62 episodes of replacement expected to achieve the target according to the rule-ofthumb estimation, 22 did (35%). Rule-of-thumb administration was associated with greater likelihood of target attainment (odds ratio, 2.12; 95% CI, 1.18-3.85; P = .01). This difference in likelihood remained significant after adjustment for covariates (odds ratio, 2.18; 95% CI, 1.04-4.56; P = .04). Conclusion In critically ill patients given potassium replacement without regard to a formal protocol, the target serum potassium concentration was achieved more often than expected according to the rule-of-thumb estimation but less than one-third of the time. (Critical Care Nurse. 2019;39[1]:e13-e18)

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Effectiveness and Safety of Magnesium Replacement in Critically Ill Patients Admitted to the Medical Intensive Care Unit in an Academic Medical Center: A Retrospective, Cohort Study

Abstract: Medically, critically ill patients who received nonprotocolized magnesium replacement achieved the target serum magnesium concentration less frequently than the "rule of thumb" estimation predicted.

Cited by 16 publications

References 8 publications

Effect of applying nurses driven electrolyte repletion protocol on electrolyte disturbances control among critically ill patients

Effect of applying nurses driven electrolyte repletion protocol on electrolyte disturbances control among critically ill patients

Intravenous Magnesium Replacement in Patients With Hypomagnesemia: Time Is of the Essence

Effectiveness and Safety of Potassium Replacement in Critically Ill Patients: A Retrospective Cohort Study

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