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Magnesium deficiency in critical illness.
J Intensive Care Med 2005 Jan-Feb; 20(1):3-17JI

Abstract

Magnesium (Mg) deficiency commonly occurs in critical illness and correlates with a higher mortality and worse clinical outcome in the intensive care unit (ICU). Magnesium has been directly implicated in hypokalemia, hypocalcemia, tetany, and dysrhythmia. Moreover, Mg may play a role in acute coronary syndromes, acute cerebral ischemia, and asthma. Magnesium regulates hundreds of enzyme systems. By regulating enzymes controlling intracellular calcium, Mg affects smooth muscle vasoconstriction, important to the underlying pathophysiology of several critical illnesses. The principle causes of Mg deficiency are gastrointestinal and renal losses; however, the diagnosis is difficult to make because of the limitations of serum Mg levels, the most common assessment of Mg status. Magnesium tolerance testing and ionized Mg2+ are alternative laboratory assessments; however, each has its own difficulties in the ICU setting. The use of Mg therapy is supported by clinical trials in the treatment of symptomatic hypomagnesemia and preeclampsia and is recommended for torsade de pointes. Magnesium therapy is not supported in the treatment of acute myocardial infarction and is presently undergoing evaluation for the treatment of severe asthma exacerbation, for the prevention of post-coronary bypass grafting dysrhythmias, and as a neuroprotective agent in acute cerebral ischemia.

Authors+Show Affiliations

University of Southern California, School of Medicine, Los Angeles, CA 90089-9317, USA.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15665255

Citation

Tong, Garrison M., and Robert K. Rude. "Magnesium Deficiency in Critical Illness." Journal of Intensive Care Medicine, vol. 20, no. 1, 2005, pp. 3-17.
Tong GM, Rude RK. Magnesium deficiency in critical illness. J Intensive Care Med. 2005;20(1):3-17.
Tong, G. M., & Rude, R. K. (2005). Magnesium deficiency in critical illness. Journal of Intensive Care Medicine, 20(1), pp. 3-17.
Tong GM, Rude RK. Magnesium Deficiency in Critical Illness. J Intensive Care Med. 2005;20(1):3-17. PubMed PMID: 15665255.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Magnesium deficiency in critical illness. AU - Tong,Garrison M, AU - Rude,Robert K, PY - 2005/1/25/pubmed PY - 2005/4/15/medline PY - 2005/1/25/entrez SP - 3 EP - 17 JF - Journal of intensive care medicine JO - J Intensive Care Med VL - 20 IS - 1 N2 - Magnesium (Mg) deficiency commonly occurs in critical illness and correlates with a higher mortality and worse clinical outcome in the intensive care unit (ICU). Magnesium has been directly implicated in hypokalemia, hypocalcemia, tetany, and dysrhythmia. Moreover, Mg may play a role in acute coronary syndromes, acute cerebral ischemia, and asthma. Magnesium regulates hundreds of enzyme systems. By regulating enzymes controlling intracellular calcium, Mg affects smooth muscle vasoconstriction, important to the underlying pathophysiology of several critical illnesses. The principle causes of Mg deficiency are gastrointestinal and renal losses; however, the diagnosis is difficult to make because of the limitations of serum Mg levels, the most common assessment of Mg status. Magnesium tolerance testing and ionized Mg2+ are alternative laboratory assessments; however, each has its own difficulties in the ICU setting. The use of Mg therapy is supported by clinical trials in the treatment of symptomatic hypomagnesemia and preeclampsia and is recommended for torsade de pointes. Magnesium therapy is not supported in the treatment of acute myocardial infarction and is presently undergoing evaluation for the treatment of severe asthma exacerbation, for the prevention of post-coronary bypass grafting dysrhythmias, and as a neuroprotective agent in acute cerebral ischemia. SN - 0885-0666 UR - https://www.unboundmedicine.com/medline/citation/15665255/Magnesium_deficiency_in_critical_illness_ L2 - http://journals.sagepub.com/doi/full/10.1177/0885066604271539?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -