Effects of magnesium on clinical outcome of critical care traumatic patients
Journal of Cellular & Molecular Anesthesia,
Vol. 2 No. 1 (2017),
1 January 2017
,
Page 9-14
https://doi.org/10.22037/jcma.v2i1.13579
Abstract
Background: Magnesium (Mg) is a necessary element in a vast number of enzymatic paths throughout the body, so, its cellular mechanisms affect clinical outcome; it is also the main second intracellular cation playing a crucial role in ATP/ADP energy conversion. Lack of Mg is usually reported in 10% of hospitalized patients worldwide. Chronic hypomagnesaemia is also in correlation with many chronic pathologic conditions. The present study was designed to assess the correlation of the serum level of Mg in ICU admitted patients with their prognosis.Materials and Methods: Through a retrospective cross-sectional design, 180 ICU admitted patients over 18 years, between 2012 and 2014 were enrolled in the study; 90 had normomagnesemia and 90 hypomagnesaemia. APACHE II score was calculated for patients after 24 hours of admission in ICU before measuring serum Mg level of each patient. Then, patients' outcomes were assessed. Mortality, hospital stay, requirement for mechanical ventilation and duration of mechanical ventilation were recorded.Results: Out of total patients with normal serum Mg 22 (22.4%) died while 36 (40%) died with hypomagnesaemia. There was no significant difference between the groups for the length of hospital stay. 48.9% of total patients with normal Mg who were admitted in ICU needed ventilator, but 78.9% of hypomagnesaemia cases were to use ventilator who were significantly higher than the other group. In terms of the time of ventilator use, a significant difference was seen between the patients with normal or low serum Mg. Individuals with normal Mg needed more days of ventilation, interestingly (26.5 vs. 17.5 days).Conclusion: Low serum magnesium could be a key factor for assessing prognosis among ICU admitted patients, especially in critically ill ones.
- Magnesium
- critical care
- clinical outcome
How to Cite
References
Bansal P, Baduni N, Bhalla J, Mahawar B. A comparative evaluation of magnesium sulphate and nitroglycerine as potential adjuncts to lidocaine in intravenous regional anaesthesia. International journal of critical illness and injury science. 2015;5(1):27-31.
De Oliveira GS J, Castro-Alves LJ, Khan JH, McCarthy RJ. Perioperative systemic magnesium to minimize postoperative pain: a meta-analysis of randomized controlled trials. Anesthesiology. 2013;119(1):178-90.
Gruenbaum SE, Bilotta F. Postoperative ICU management of patients after subarachnoid hemorrhage. Curr Opin Anaesthesiol. 2014;27(5):489-93.
Velissaris D, Karamouzos V, Pierrakos C, Aretha D, Karanikolas M. Hypomagnesemia in Critically Ill Sepsis Patients. Journal of clinical medicine research. 2015;7(12):911-8.
Dabbagh A, Bastanifar E, Foroughi M, Rajaei S, Keramatinia AA. The effect of intravenous magnesium sulfate on serum levels of N-terminal pro-brain natriuretic peptide (NT pro-BNP) in elective CABG with cardiopulmonary bypass. J Anesth. 2013;27(5):693-8.
Dabbagh A, Elyasi H, Razavi SS, Fathi M, Rajaei S. Intravenous magnesium sulfate for post-operative pain in patients undergoing lower limb orthopedic surgery. Acta Anaesthesiol Scand. 2009;53(8):1088-91.
Ferasatkish R, Dabbagh A, Alavi M, Mollasadeghi G, Hydarpur E, Moghadam AA, et al. Effect of magnesium sulfate on extubation time and acute pain in coronary artery bypass surgery. Acta Anaesthesiol Scand. 2008;52(10):1348-52.
Bilotta F, Gelb AW, Stazi E, Titi L, Paoloni FP, Rosa G. Pharmacological perioperative brain neuroprotection: a qualitative review of randomized clinical trials. Br J Anaesth. 2013;110 Suppl 1:i113-20.
Murphy JD, Paskaradevan J, Eisler LL, Ouanes JP, Tomas VA, Freck EA, et al. Analgesic efficacy of continuous intravenous magnesium infusion as an adjuvant to morphine for postoperative analgesia: a systematic review and meta-analysis. Middle East journal of anaesthesiology. 2013;22(1):11-20.
Pascual-Ramirez J, Gil-Trujillo S, Alcantarilla C. Intrathecal magnesium as analgesic adjuvant for spinal anesthesia: a meta-analysis of randomized trials. Minerva anestesiologica. 2013;79(6):667-78.
Dabbagh A, Rajaei S, Shamsolahrar MH. The effect of intravenous magnesium sulfate on acute postoperative bleeding in elective coronary artery bypass surgery. J Perianesth Nurs. 2010;25(5):290-5.
Mirkheshti A, Aryani MR, Shojaei P, Dabbagh A. The Effect of Adding Magnesium Sulfate to Lidocaine Compared with Paracetamol in Prevention of Acute Pain in Hand Surgery Patients Under Intravenous Regional Anesthesia (IVRA). Int J Prev Med. 2012;3(9):616-21.
Safavi M, Honarmand A. Admission hypomagnesemia--impact on mortality or morbidity in critically ill patients. Middle East journal of anaesthesiology. 2007;19(3):645-60.
Das K, Ozdogan M, Karateke F, Uzun AS, Sozen S, Ozdas S. Comparison of APACHE II, P-POSSUM and SAPS II scoring systems in patients underwent planned laparotomies due to secondary peritonitis. Annali italiani di chirurgia. 2014;85(1):16-21.
Thorsen K, Soreide JA, Soreide K. Scoring systems for outcome prediction in patients with perforated peptic ulcer. Scandinavian journal of trauma, resuscitation and emergency medicine. 2013;21:25.
Zafar MS, Wani JI, Karim R, Mir MM, Koul PA. Significance of serum magnesium levels in critically ill-patients. International journal of applied & basic medical research. 2014;4(1):34-7.
Limaye CS, Londhey VA, Nadkart MY, Borges NE. Hypomagnesemia in critically ill medical patients. The Journal of the Association of Physicians of India. 2011;59:19-22.
Soliman HM, Mercan D, Lobo SS, Melot C, Vincent JL. Development of ionized hypomagnesemia is associated with higher mortality rates. Critical care medicine. 2003;31(4):1082-7.
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