Examining the Frequency of Hypomagnesemia in Multiple Trauma Patients Hospitalized in the Intensive Care Unit
Abstract
Background: Electrolyte imbalance is one of the influential causes in determining the outcome of traumatic patients. One of the electrolytes that get less attention from healthcare providers is magnesium. Therefore, this study investigated the frequency of hypomagnesemia in trauma patients hospitalized in the intensive care unit.
Methods: The descriptive-cross-sectional study was conducted after approval at Zahedan University of Medical Sciences on 118 patients with multiple traumas from 2021 to 2022. Patients were selected by convenience sampling method according to the inclusion criteria. Age, sex, weight, body mass index, level of consciousness, and level of blood serum electrolytes were measured and recorded on the first and fifth days after hospitalization. The data were analyzed and compared using descriptive statistics, chi-square, and independent t-test.
Results: Of 118 patients studied, 81 (68.6%) were male, and 38 (31.4%) were female. On the fifth day after hospitalization, the mean serum magnesium level of the patients was 1.4 ± 0.81 mg/dL. 87 patients (73.7%) had normal magnesium serum levels, 27 patients (29.9%) had hypomagnesemia, and 4 patients (3.4%) had severe hypomagnesemia. No statistically significant relationship existed between hypomagnesemia and gender, age group, and comorbidity diseases. The level of other blood serum electrolytes on the fifth day after hospitalization, age, weight, body mass index, and status of consciousness was not statistically significant between the two groups of patients with hypomagnesemia and without hypomagnesemia.
Conclusion: Trauma and the subsequent treatment measures lead to decreased magnesium serum levels in intensive care patients. Therefore, the normal serum level of other electrolytes should not be considered a diagnostic indicator for the normality of magnesium serum level. Magnesium should be measured along with other electrolytes to make a timely decision to replace magnesium supplements in a patient with hypomagnesemia.
[2] Sanders GT, Huijgen HJ, Sanders R. Magnesium in disease: a review with special emphasis on the serum ionized magnesium. Clin Chem Lab Med. 1999; 37(11-12):1011-33.
[3] Agus ZS. Mechanisms and causes of hypomagnesemia. Curr Opin Nephrol Hypertens. 2016; 25(4):301-7.
[4] Swaminathan R. Magnesium metabolism and its disorders. Clin Biochem Rev. 2003; 24(2):47-66
[5] Agus ZS. Hypomagnesemia. J Am Soc Nephrol. 1999; 10(7):1616-22.
[6] Buckley MS, Leblanc JM, Cawley MJ. Electrolyte disturbances associated with commonly prescribed medications in the intensive care unit. Crit Care Med. 2010; 38(6 Suppl):S253-64.
[7] Hersh T, Siddiqui DA. Magnesium and the pancreas. Am J Clin Nutr. 1973; 26(3):362-6.
[8] Upala S, Jaruvongvanich V, Wijarnpreecha K, Sanguankeo A. Hypomagnesemia and mortality in patients admitted to intensive care unit: a systematic review and meta-analysis. QJM. 2016; 109(7):453-9.
[9] Pham PC, Pham PA, Pham SV, Pham PT, Pham PM, Pham PT. Hypomagnesemia: a clinical perspective. Int J Nephrol Renovasc Dis. 2014; 7:219-30.
[10] Jahnen-Dechent W, Ketteler M. Magnesium basics. Clin Kidney J. 2012; 5(Suppl 1):i3-i14.
[11] Ishimura E, Okuno S, Yamakawa T, Inaba M, Nishizawa Y. Serum magnesium concentration is a significant predictor of mortality in maintenance hemodialysis patients. Magnes Res. 2007; 20(4):237-44
[12] Fein P, Weiss S, Ramos F, Singh P, Chattopadhyay J, Avram MM. Serum magnesium concentration is a significant predictor of mortality in peritoneal dialysis patients. Adv Perit Dial. 2014; 30:90-3
[13] Lacson E, Wang W, Ma L, Passlick-Deetjen J. Serum Magnesium and Mortality in Hemodialysis Patients in the United States: A Cohort Study. Am J Kidney Dis. 2015; 66(6):1056-66.
[14] Fairley J, Glassford NJ, Zhang L, Bellomo R. Magnesium status and magnesium therapy in critically ill patients: A systematic review. J Crit Care. 2015; 30(6):1349-58.
[15] Peyvandi Yazdi A, Hashemi E, Salehi M, Masoumzadeh M, Razavi M. Evaluation of the prevalence of hypomagnesemia in the first 24th hour after selective operations in intensive care unit patients. Quarterly of the Horizon of Medical Sciences. 2014;20(1):29-33.
[16] Frankel H, Haskell R, Lee SY, Miller D, Rotondo M, Schwab CW. Hypomagnesemia in Trauma Patients. World J Surg. 1999; 23(9):966-9.
[17] Polderman KH, Bloemers FW, Peerdeman SM, Girbes AR. Hypomagnesemia and hypophosphatemia at admission in patients with severe head injury. Crit Care Med. 2000; 28(6):2022-5.
[18] Tabas EE, Keykha A, Abbaszadeh A, Rafiei H, Enayati H, Hoseini BMK, et al. The effect of the sedation protocol on the level of consciousness in ventilator-dependent trauma patients hospitalized in Intensive Care Unit (ICU). Medical - Surgical Nursing Journal. 2015;4(1):22-30.
[19] Taran Z, Namadian M, Faghihzadeh S, Naghibi T. The Effect of Sedation Protocol Using Richmond Agitation-Sedation Scale (RASS) on Some Clinical Outcomes of Mechanically Ventilated Patients in Intensive Care Units: a Randomized Clinical Trial. J Caring Sci. 2019; 8(4):199-206.
[20] Keykha A, Dabiri S, Dashipour A, Rahat Dahmardeh A. Evaluation of procalcitonin level as a prognostic and diagnostic marker for the onset of sepsis therapy. AJMBES. 2017;19(4):1058-63
[21] Shawkat H, Westwood M-M, Mortimer A. Mannitol: a review of its clinical uses. Continuing Education in Anaesthesia, Critical Care & Pain. 2012;12(2):82-5.
[22] Fink ME. Osmotherapy for Intracranial Hypertension: Mannitol Versus Hypertonic Saline. Continuum (Minneap Minn). 2012; 18(3):640-54.
[23] Zhang W, Neal J, Lin L, Dai F, Hersey DP, McDonagh DL, et al. Mannitol in critical care and surgery over 50+ years: a systematic review of randomized controlled trials and complications with meta-analysis. J Neurosurg Anesthesiol. 2019; 31(3):273-84.
[24] Wall M. Medical Treatment of Idiopathic Intracranial Hypertension (IIH). Neuro-Ophthalmology: Global Trends in Diagnosis, Treatment and Management. 2019:61-6
[25] Touyz RM. Magnesium in clinical medicine. Front Biosci. 2004; 9:1278-93.
[26] Olerich MA, Rude RK. Should we supplement magnesium in critically ill patients? New Horiz. 1994;2(2):186-92.
[27] Sadeghi-Bojd S, Noori N, Zarifi E, Teimouri A. Prevalence of Hypomagnesaemia in Children Admitted to the Pediatric Intensive Care Unit and its Related Factors in Zahedan, Iran. International Journal of Pediatrics. 2021;9(5):13539-49.
[28] Garnett MR, Corkill RG, Blamire AM, Rajagopalan B, Manners DN, Young JD, et al. Altered cellular metabolism following traumatic brain injury: a magnetic resonance spectroscopy study. J Neurotrauma. 2001;18(3):231-40.
| Files | ||
| Issue | Vol 10 No 4 (2024): Autumn |
|
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/aacc.v10i4.16266 | |
| Keywords | ||
| Hypomagnesemia, Hypermagnesemia, Trauma Injuries, Water-Electrolyte Imbalance, Multiple Trauma | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
