Hypomagnesemia in critically ill patients

Hansen, Bent-Are; Bruserud, Øyvind

doi:10.1186/s40560-018-0291-y

Cited by 126 publications

(131 citation statements)

References 127 publications

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“…The incidence seems to highly variable across numerous studies, ranging from 14% to 61%. 4 In this study the incidence was high as 53%, which is similar to the incidence as shown in study by Singhi et al, who found a prevalence of 60%. 5 Male gender showed a preponderance to hypomagnesemia as compared to females as shown by several other studies as well.…”

Section: Discussionsupporting

confidence: 89%

Risk factors and clinical outcome of hypomagnesemic patients in pediatric intensive care

Shankar¹,

Kavya²,

Reddy³

2020

Int J Contemp Pediatr

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Background: Hypomagnesemia is a common finding in current medical practice, especially in critically ill patients. Magnesium ion plays a vital role in various metabolic processes in body and its deficiency leading to serious clinical consequences. Since hypomagnesemia is most often asymptomatic, it goes unsuspected and therefore undiagnosed. Hence, early detection of hypomagnesemia has prognostic and therapeutic implications. It is imperative to understand the various risk factors and their clinical outcome that is associated with hypomagnesemia.Methods: This is an observational study done in a tertiary centre in Bangalore, India where-in 100 children who met the inclusion criteria, admitted to the PICU were recruited and prospectively studied. Serum Magnesium along with various clinical and biochemical parameters were correlated to enumerate the various risk factors associated with hypomagnesemia.Results: In this study authors found the incidence of hypomagnesemia to be around 53%. Authors found higher incidence in age group of 1-5 yrs (40%) and least were in the age groups of <1 year and more than 10 years (19%) and there was no gender preponderance. Authors also evaluated the various risk factors associated with hypomagnesemia. There was significant association of hypocalcemia (60%) and hypokalemia (45.2%) with hypomagnesemia. Infections (33.9%) and neurological disorders (26.41%) seemed to collectively comprise around 60% of the hypomagnesemic group. All patients admitted secondary to sepsis and Traumatic Brain Injury (TBI) had hypomagnesemia proving to be a significant risk factor. Authors also found increased mortality among hypomagnesemic group. However, found no association between low serum magnesium and PICU stay.Conclusions: There is high prevalence of hypomagnesemia in critically ill patients and is associated with a higher mortality. It is also commonly associated with infections, CNS disorders, respiratory diseases and metabolic derangements like hypokalaemia and hypocalcaemia. There is no association of Hypomagnesemia with duration of PICU stay.

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Section: Discussionsupporting

confidence: 89%

Risk factors and clinical outcome of hypomagnesemic patients in pediatric intensive care

Shankar¹,

Kavya²,

Reddy³

2020

Int J Contemp Pediatr

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“…It is also possible that diuresis, associated with polyionic fluid administration via i.v. and NGT routes, may have contributed to increased renal loss of calcium and magnesium [19,20].…”

Section: Discussionmentioning

confidence: 99%

Continuous fluid infusion per rectum compared with intravenous and nasogastric fluid administration in horses

Khan

Hallowell

Underwood

et al. 2019

Equine Veterinary Journal

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Summary Background Rectal fluid administration may offer a simple, safe and inexpensive alternative to intravenous or nasogastric fluid therapy in equine clinical cases. Objectives To evaluate the tolerance and effects of rectally administered fluid and compare the measurements of haemodilution and intravascular volume with those during nasogastric and intravenous fluid administration. Study design Randomised controlled experimental trial. Methods Six clinically normal Standardbred geldings were used in a 4‐way crossover study: each received three different fluid treatments (intravenous, nasogastric and rectal) at 5 mL/kg/h for 6 h and underwent a control (no treatment) with water and feed withheld. Bodyweight was measured at baseline and 6 h. Packed cell volume (PCV), total solids (TS), albumin, electrolytes, lactate, urine specific gravity, vital parameters, gastrointestinal borborygmi and central venous pressure were measured every 2 h. Results Rectal fluid administration with plain water was well tolerated and caused clinical chemistry changes consistent with haemodilution, indicating absorption. Mean (95% confidence interval) PCV decreased from 40% [40–42] at 0 h to 35% [34–36] at 6 h during rectal fluid treatment (P<0.001), similar to decreases in PCV occurring also with i.v. and nasogastric (NGT) treatment (P<0.001). The TS also decreased with i.v. and rectal fluid (P<0.001). There was a decrease in bodyweight in the control (P<0.001) but not with any of the fluid treatments. Main limitations A small sample size of healthy, euhydrated horses and a relatively short duration of fluid administration was used. Conclusions Rectal fluid administration requires clinical evaluation, but may offer an inexpensive, safe alternative or adjunct to i.v. fluid administration, particularly when administration via NGT is not possible or contraindicated. The Summary is available in Portuguese ‐ see Supporting Information

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“…It is required for energy production, oxidative phosphorylation, and glycolysis, and it aids in the development of the skeletal system. Mg is also necessary for the synthesis of DNA, RNA, and the antioxidant, glutathione [5,6]. In patients with normal renal function, Mg is filtered in the glomerulus.…”

Section: Introductionmentioning

confidence: 99%

Effect of Magnesium Supplementation to Prevent Nephrotoxicity on the Antitumor Activity of Cisplatin

Yasuda¹,

Kishimoto²,

Ebara³

et al. 2019

JCTR

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Background: Cisplatin (CDDP) is one of the most widely used anticancer drugs, but CDDP often leads to nephrotoxicity, which limits its clinical effectiveness. Magnesium (Mg) supplementation is recommended for the avoidance of CDDP-induced nephrotoxicity. However, there is a concern that exposing cancer cells to Mg may suppress the antitumor effect of CDDP. Methods: Transporter expression, intracellular platinum and Mg levels, and cytotoxicity of CDDP after Mg exposure were assessed in human hepatocellular carcinoma (HepG2) and human ovarian carcinoma (2008) cells. Results: In HepG2 cells, Mg exposure significantly increased mRNA levels of multidrug and toxin extrusion 1 (MATE1), which mediates the renal excretion of CDDP, but did not alter its protein levels, including those of organic cation transporter 1 (OCT1), which mediates CDDP uptake in renal tubular and cancer cells, and multidrug resistance-associated protein 2 (MRP2), which mediates CDDP efflux in cancer cells. In 2008 cells, MATE1 protein expression could not be detected, but a slight increase in MRP2 and OCT1 protein expression was observed after Mg exposure. Intracellular Mg levels were significantly increased due to Mg exposure in both cells. However, intracellular platinum levels and cytotoxicity of CDDP were not affected in both cells, even with 2 mM Mg co-exposure. Conclusion: This study found that Mg exposure only slightly changed transporter expression and did not affect intracellular platinum levels and CDDP cytotoxicity in HepG2 and 2008 cells. Thus, Mg supplementation can be used to avoid CDDP-induced renal toxicity without affecting the accumulation of CDDP in cancer cells and its cytotoxicity.

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Hypomagnesemia in critically ill patients

Cited by 126 publications

References 127 publications

Risk factors and clinical outcome of hypomagnesemic patients in pediatric intensive care

Risk factors and clinical outcome of hypomagnesemic patients in pediatric intensive care

Continuous fluid infusion per rectum compared with intravenous and nasogastric fluid administration in horses

Effect of Magnesium Supplementation to Prevent Nephrotoxicity on the Antitumor Activity of Cisplatin

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