Development of ionized hypomagnesemia is associated with higher mortality rates

Abstract

Development of ionized hypomagnesemia during an ICU stay is associated with a worse prognosis. It is often associated with the use of diuretics and the development of sepsis. Monitoring of ionized magnesium levels may have prognostic, and perhaps therapeutic, implications.

Prevalence of Hypomagnesemia and Its Predictive Prognostic Value in Critically Ill Medical Patients

“…Salem et al 25 observed that progressive magnesium deficiency and hypomagnesemia are strongly associated with increased mortality in experimental sepsis and magnesium replacement provides significant protection against endotoxin challenge. Sepsis is an independent risk factor for developing hypomagnesemia during ICU stay as observed by Soliman et al 17 In our study we found that the incidence of sepsis was much more common in patients with low magnesium in compared to normal magnesium (p value ). CS Limaye et al 20 also observed increased association of sepsis as twice as common in hypomagnesaemic patients.In our study hypomagnesemia was more common in diabetic patients (p value).…”

“…Chernow et al 8 ( 41% vs 13%), Rubiez et al 14 (46% vs 25%), and Safavi et al 18 (55% vs 35%) had found higher mortality whereas Guerin et al 9 (18% vs 17%) had found no difference in mortality between hypomagnesaemic and normomagnesemic patients in their studies.The higher mortality in hypomagnesaemic patients can be explained by increased association of morbidities like more need and longer duration of ventilatory assistance, association of sepsis and diabetes, other electrolyte abnormalities like hypocalcemia and hypokalemia in compared to patients with normal magnesium levels.The length of ICU stay and total hospital duration both were longer in hypomagnesaemic patients. Soliman et al 17 also observed longer duration of ICU stay in patients with low magnesium. They also found the length of ICU stay as an independent risk factor for hypomagnesemia development.…”

“…Various studies evaluated hypomagnesemia in critically ill patients previously ranging from 14% -70%. [12][13][14][15][16][17][18] In our study a relatively higher mortality was observed among patients with hypomagnesemia compared to normomagnesemic patients. The relation between hypomagnesemia and mortality varies from study to study.…”

“…Soliman et al 17 found that those patients who develop ionized hypomagnesemia during their ICU stay had higher APACHE 2 score on admission. Guerin et al 9 and Rubiez et al…”

Effect of Magnesium Level to the Development of Delirium in Patients Under Sedation in Intensive Care Unit

“…İntra venöz uygulamalarında yüksek serum seviyeleri iyi tolere edilebilir. Yoğun bakıma yatışta kritik hastalıkla magnesyum seviyelerinde düşüş sıklığı ve bu faktörün olumsuz klinik sonuçla ilişkisi bir çok araştırmada gösterilmiştir (8)(9)(10). Çalışmamızın amacı yoğun bakım hastalarında hipomagnezeminin gerek yoğun bakıma girişte gerekse tedavi sırasında sıklıkla karşılaşılan bir durum olduğunu göstermek ve deliryum sıklığı ile ilişkisini araştırmaktır.…”