Should we measure ionized magnesium?

Foley, C. W.; Zaritsky, Arno

doi:10.1097/00003246-199812000-00012

Cited by 14 publications

(7 citation statements)

References 8 publications

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“…Mg level assessment is difficult, because Mg is mostly intracellular and there is no simple method to measure total body Mg. Because Mg is primarily a cofactor in intracellular biochemical reactions, and almost 99% of total body Mg is intracellular, the practice of measuring Mg in blood serum alone has been questioned, and methods for measurement of total cellular Mg in erythrocytes (tMge) have been developed. However, intracellular ionized Mg concentration is physiologically much more relevant [ 22 ], and the question of whether ionized Mg should be measured in clinical practice has been raised [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Hypomagnesemia in Critically Ill Sepsis Patients

et al. 2015

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Magnesium (Mg), also known as “the forgotten electrolyte”, is the fourth most abundant cation overall and the second most abundant intracellular cation in the body. Mg deficiency has been implicated in the pathophysiology of many diseases. This article is a review of the literature regarding Mg abnormalities with emphasis on the implications of hypomagnesemia in critical illness and on treatment options for hypomagnesemia in critically ill patients with sepsis. Hypomagnesemia is common in critically ill patients, and there is strong, consistent clinical evidence, largely from observational studies, showing that hypomagnesemia is significantly associated with increased need for mechanical ventilation, prolonged ICU stay and increased mortality. Although the mechanism linking hypomagnesemia with poor clinical outcomes is not known, experimental data suggest mechanisms contributing to such outcomes. However, at the present time, there is no clear evidence that magnesium supplementation improves outcomes in critically ill patients with hypomagnesemia. Large, well-designed clinical trials are needed to evaluate the role of magnesium therapy for improving outcomes in critically ill patients with sepsis.

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Section: Discussionmentioning

confidence: 99%

Hypomagnesemia in Critically Ill Sepsis Patients

et al. 2015

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“…However, only the total magnesium (Mg) concentrations were measured; ionized magnesium (iMg) concentrations were not, even though this form of magnesium is the physiologically active unbounded portion. 8) In fact, studies comparing Mg and iMg concentrations have revealed a poor correlation, particularly after cardiopulmonary bypass or a massive transfusion. 9,10) The need for parallel measurement of Mg and iMg concentrations was suggested.…”

Section: Introductionmentioning

confidence: 99%

Changes in Ionized and Total Magnesium Concentration during Spinal Surgery

Chang

Nam

Lee

et al. 2007

Korean J Anesthesiol

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Background: The incidence of postoperative hypomagnesemia in patients undergoing spinal surgery has been reported to be 70%. Ionized magnesium is considered to be the biologically active form, but until the early 1990s, only the total magnesium concentration could be measured. Currently, the ionized magnesium concentration as well as total magnesium concentration can be assessed due in part to the development of a selective electrode. The aim of this study was to more fully characterize the changes in the total and ionized magnesium concentrations in patients undergoing elective spinal fusion surgery. Methods: The total and ionized magnesium, creatinine, albumin, urinary magnesium concentration, hematocrit, total amount of fluid administration, transfusion, blood loss, and urine output were evaluated both preoperatively and postoperatively in each patient. Results: The total and ionized magnesium concentrations decreased from 0.783 mM/L and 0.529 mM/L preoperatively to 0.717 mM/L and 0.511 mM/L during the postoperative period, respectively. Conclusions: The incidence of total hypomagnesemia during spinal surgery was 15% but the incidence of ionized hypomagnesemia was only 3%.

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“…Magnesium, a largely intracellular cation, exists in several states in the body, but only the ionized form (55 %) is biologically active [22,23]. Altura & Altura also suggested that total serum magnesium may not be a sensitive blood variable or analyte [12].…”

Section: Discussionmentioning

confidence: 99%

“…ISE probe can make accurate, linear and rapid measurements of ionized magnesium with no or negligible interference from cations or trace elements [12,13,22,23]. Using NMR spectroscopy, digital imaging microscopy, and confocal laser scanning, their lab then went on to show that a high correlation existed between serum IMg 2+ and intracellular magnesium levels in a wide array of mammalian tissues [24][25][26][27][28].…”

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confidence: 99%