Prevalence of hypomagnesemia in children admitted to pediatric intensive care unit and its correlation with patient outcome

Abstract

Background: Magnesium deficiency is common in critical illness and is said to be associated with increased need for mechanical ventilation, mortality and prolonged ICU stay. The knowledge of hypomagnesemia is essential as available data is scarce and it could have prognostic and therapeutic implications. This study was undertaken to estimate the prevalence of hypomagnesemia at the time of admission in PICU and its correlation with length of PICU stay, duration on mechanical ventilator and outcome at the end of hospital stay-death or discharge.Methods: This is a prospective observational study including 343 children aged 1month to 12years admitted to PICU. Detailed history taking and clinical examination was done for all enrolled children. At admission, blood was collected for estimation of serum magnesium. Patients were categorized into three groups i.e., hypomagnesemia, normomagnesemia and hypermagnesemia and data was analysed.Results: Out of 343 children, 28% had hypomagnesemia, 7.3% had hypermagnesemia and 64.7% had normomagnesemia. Hypomagnesemia was more common in neurological disorders. No association was found between magnesium and length of mechanical ventilation. PICU stay was significantly longer in hypomagnesemia group (p=0.031). 37.5% patients with hypomagnesemia also had hypocalcemia and 35.4% had hypokalemia. Mortality rate was higher in those with hypomagnesemia (30.2%) compared to those with normomagnesemia (22.1%).Conclusions: Patients with hypomagnesemia had increased duration of PICU stay, other associated electrolyte abnormalities and higher mortality. Hence monitoring of magnesium levels in critically ill patients is indicated.

Serum Magnesium Level in Protein-Energy Malnourished Children

“…63.7% with male to female ratio of 1.75:1. In the study conducted by Dandinavar et al 14 there were 56.6% males whereas there were 62% males in the study conducted by Fatima et al 16 These results were similar to ours possibly because more male children were brought for management.…”

“…13 Regular intake of legumes, nuts, bananas and whole grains can prevent magnesium deficiency. 14 A wide variety of clinical conditions such as PEM, malabsorption, hypoalbuminaemia, sepsis, hypothermia, etc which are very common among children in developing countries are also a cause of low magnesium level. 14 Magnesium acts as a bronchodilator and also has antiinflammatory properties.…”

“…14 A wide variety of clinical conditions such as PEM, malabsorption, hypoalbuminaemia, sepsis, hypothermia, etc which are very common among children in developing countries are also a cause of low magnesium level. 14 Magnesium acts as a bronchodilator and also has antiinflammatory properties. 15 It not only impedes the contractility of smooth muscle but also the release of histamine and acetyl choline thus depressing the excitability of smooth muscle fibers by reducing uptake of calcium by the cells.…”

Prevalence of Hypomagnesemia among Elderly Patients attending a Tertiary Care Center: A Descriptive Cross-sectional Study

“…12 Dandinavar et al, in their study, have concluded that child patients with hypomagnesemia had an increased duration of PICU stay and a higher mortality rate. 13 The study's limitation was that it is a single institution study, and the sample size isn't effective in formulating a consensus. The inclusion of critically ill patients could also have helped to broaden the understanding of the importance of hypomagnesemia in critical care settings.…”

Nghiên Cứu Nồng Độ Magne Máu Ở Bệnh Nhân Nặng Tại Khoa Nhi Cấp Cứu- Hồi Sức Tích Cực Và Chống Độc, Bệnh Viện Phụ Sản - Nhi Đà Nẵng

“…Nhóm bệnh tim mạch (5,8%) và chấn thương (1,2%) hiếm gặp hơn. Nghiên cứu của Dandinavar (2019) cũng ghi nhận bệnh thần kinh (36,4%) và bệnh hô hấp (26,8%) là 2 nhóm bệnh nhiều nhất ở bệnh nhi nặng điều trị tại khoa hồi sức[4]. Nghiên cứu của Erdogan (2018) ghi nhận các nhóm bệnh này với tỷ lệ khá tương tự: bệnh hô hấp 20,9%, bệnh thần kinh 20,3%, bệnh tim mạch 18,9%, nhiễm trùng huyết 10,8%[5].…”