effects of magnesium on clinical outcome of critical care traumatic patients

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.