| Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc |
| Journal website http://www.jocmr.org |
Review
Volume 7, Number 12, December 2015, pages 911-918
Hypomagnesemia in Critically Ill Sepsis Patients
Tables
| Author | Origin/year | Study design | Findings |
|---|---|---|---|
| Alves et al [13] | Criciuma, Brazil, 2013 | Cohort study, 232 ICU patients | Hypomagnesemia is independent risk factor for non-recovery of renal function. |
| Arnold et al [21] | Wales, UK, 1995 | Magnesium loading test, 20 ICU patients | Normal Mg concentrations in plasma, red blood cell or mononuclear blood cell cannot exclude magnesium depletion. |
| Chen et al [9] | Hangzhou, China, 2015 | Single-center prospective observational study, 374 ICU patients | Hypomagnesemia in 102 patients (27.27%), associated with higher SOFA scores, longer ICU stay and higher mortality 54.90% vs. 33.88%, P = 0.01. Serum magnesium level was independent risk factor for death. |
| Chernow et al [14] | Boston, MA. USA, 1989 | Observational study, 193 postoperative ICU patients | Sixty-one percent of patients had hypomagnesemia on ICU admission. Severe hypomagnesemia (serum Mg ≤ 1.0 mEq/dL) associated with aminoglycoside therapy, hypokalemia and higher mortality. |
| Cojocaru et al [10] | Bucharest, Romania, 2009 | Observational study 53 patients with acute stroke and acute infection | Hypomagnesemia in patients with acute bacterial infections occurred within days, persisted for weeks, did not correlate with disease severity. |
| Dabbagh et al [15] | Riyadh, Saudi Arabia, 2006 | Prospective observational study, 71 ICU patients | Forty-one of 71 patients (60%) had hypomagnesemia. Daily Mg supplementation > 1 g/day associated with lower mortality |
| Escuela et al [16] | Zaragoza, Spain, 2005 | Prospective observational study, 144 ICU patients | Hypomagnesemia in 52.5% of patients on ICU admission ionized hypermagnesemia associated with higher mortality. No association between hypomagnesemia and mortality |
| Fiaccadori et al [24] | Parma, Italy, 1988 | Prospective study, 32 ICU patients | Three of 32 patients (9.4%) had low serum Mg (≤ 0.7 mmol/L) but normal muscle Mg. Fifteen of 32 patients (47%) had low muscle Mg but normal serum Mg levels. |
| Guerin et al [17] | Lyon, France, 1996 | Prospective observational study, 179 ICU patients | On ICU admission, hypomagnesemia in 79 (44%) patients, hypermagnesemia in 10 (6%). High Mg level associated with higher mortality, no association between low Mg and Mge and mortality. |
| Huijgen et al [18] | Amsterdam, Netherlands, 2000 | Prospective multicenter study, 115 ICU patients | Negative correlation between serum albumin and ionized magnesium. No correlation between low extracellular or intracellular magnesium and outcome. |
| Kumar et al [8] | Maharashtra, India, 2015 | Prospective observational study over 1-year, 601 ICU patients | Hypomagnesemia in 25% of patients, associated with greater need for mechanical ventilation, longer ICU stay and higher mortality (38.56% vs. 14.73%). |
| Limaye et al [6] | Mumbai, India, 2011 | Prospective observational study, 100 ICU patients | Hypomagnesemia associated with mechanical ventilation need (P < 0.05), and duration (P < 0.05), increased incidence of sepsis (38% vs. 19%, P < 0.05) and higher mortality (57.7% vs. 31.7%, P < 0.05). |
| Moskowitz et al [19] | Boston, MA, USA, 2014 | Retrospective study, 8,922 ICU patients over 8 years | Hypomagnesemia present in 22.6% of ICU patients, associated with lactic acidosis. |
| Reinhart et al [5] | Marshfield, WI, USA, 1985 | Observational study, 102 medical ICU patients | Hypomagnesemia in 20% of patients, hypermagnesemia in 9% of patients. Of all ions, Mg had the highest prevalence of abnormal values. |
| Rubeiz et al [20] | Detroit, MI, USA, 1993 | Prospective observational study, 381 consecutive acutely ill patients | Patients with hypomagnesemia had comparable APACHE II scores but twice the mortality compared to patients with normal magnesium (P < 0.01). |
| Ryzen et al [25] | Los Angeles, CA, USA, 1985 | Observational study, 94 consecutive ICU patients | 65% of patients with normal creatinine had hypomagnesemia. |
| Safavi, Honarmad [11] | Isfahan, Iran, 2007 | Retrospective study, 100 ICU patients | Development of hypomagnesemia in ICU associated with higher SOFA scores, need for ventilator support and mortality. |
| Santos et al 2010 [12] | Sao Paulo, Brazil, 2010 | Fifty-four hospitalized AIDS patients with acute kidney injury | Hypomagnesemia associated with non-recovery of renal function and with mortality. |
| Soliman et al [7] | Brussels, Belgium, 2003 | Prospective observational study, 446 patients | Patients who developed hypomagnesemia during ICU stay had higher prevalence of sepsis, septic shock, longer ICU stay and higher mortality. |
| Zafar et al [2] | New Delhi, India, 2014 | Prospective observational study, 70 ICU patients | Hypomagnesemia present in 24.29% of ICU patients, associated with higher mortality (74.7% vs. 36%, P = 0.004). |
| Author | Origin/year | Study design | Findings |
|---|---|---|---|
| Esen et al [28] | Istanbul, Turkey, 2005 | Randomized experimental study, intraperitoneal sepsis model, 126 male rats | Magnesium attenuated the increased blood brain barrier permeability and reduced brain edema |
| James et al [33] | Johannesburg, South Africa, 1988 | Experimental study in baboons receiving adrenaline infusion | Mg infusion abolished arrhythmias, increased CO and SV and reduced SVR. Mg has antiarrhythmic and alpha-adrenergic antagonist effects |
| Johansson et al [23] | Jonkoping, Sweden, 2007 | Blood samples from 40 healthy volunteers and 46 patients | Weak correlation between free ionized magnesium (iMg2+) and total Mg in critical illness. Free ionized magnesium (iMg2+) is most useful for estimating Mg status |
| Lee et al [27] | Taipei, Taiwan, 2011 | Ninety-six adult male rats | In endotoxemia, MgSO4 mitigates oxidative stress, acute lung injury, likely via calcium channel and NMDA antagonism |
| Liu et al [31] | Shanghai, China, 2013 | Murine macrophage cells in normal or low magnesium | Magnesium deficiency promotes HMGB1 nucleus to cytoplasm translocation and HMGB1 mRNA expression and activates NF-kappaB signaling |
| Malon et al [22] | Warsaw, Poland, 2014 | Sixty-nine ICU patients, measured erythrocyte and serum iMg, and total magnesium (tMg) | Intracellular Mg concentration preferred for Mg status evaluation. iMge most relevant for diagnosing hypo- or hyper-magnesemia |
| Malpuech-Brugere et al [34] | Theix, France, 2000 | Male Wistar rat inflammatory model | Increased cytokine concentration experimental magnesium deficiency |
| Pranskunas et al [30] | Leeuwarden, Netherlands, 2011 | Single-center open label study, 14 ICU patients | Magnesium did not improve microcirculation in patients with septic shock |
| Salem et al [29] | Washington, DC, USA, 1995 | Randomized controlled studies - endotoxin challenge on 299 rats | Mg deficiency strongly associated with mortality. Mg replacement protects from endotoxin challenge. Cellular injury associated with Mg abnormalities |
| Sayeed et al [26] | Maywood, IL, USA, 1989 | Endotoxic shock in hypovolemic rats | Hepatic Mg content lower in endotoxic rats. Diltiazem treatment before endotoxin injection restored hepatic Mg levels |
| Watanabe et al [35] | Tokyo, Japan, 2011 | Experiment on male ICR mice | Significantly reduced cardiac tolerance to hypoxia in Mg deficiency |