Journal of Pediatric Perspectives

Journal of Pediatric Perspectives

Serum Magnesium Level of Patients Admitted to the Pediatric Intensive Care Unit: A Prospective Analytical Study

Document Type : original article

Authors
Maryam Shahrokhi 1
Saeid Sadat Mansouri 2
Ali Afzali 3
Amir Mohammad Davarifardpur 3
Negar Shafaei-Bajestani 4
1 Assistant Professor, Clinical Research Development Center of Imam Khomeini Hospital, Jiroft University of Medical Sciences, Jiroft, Iran.
2 Assistant Professor, Pediatric Diseases Research Centre, Guilan University of Medical Sciences, Rasht, Iran.
3 Pharmacy Student, Student Research Committee, School of Pharmacy, Guilan University of Medical Sciences, Rasht, Iran.
4 Assistant Professor, Department of Pharmacology, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran.
10.22038/ijp.2024.80038.5462
Abstract
Background: The mean prevalence of hypomagnesemia in pediatric intensive care units is 18-44% in different studies. In patients with hypomagnesemia compared to patients with normal magnesium levels, there is a significant difference in terms of mortality, duration of hospitalization and ICU stay, the need for mechanical ventilation and its duration. The aim of this study was assessing the prevalence of hypomagnesemia in PICU and the impact of it on patients’ prognosis.
Methods: The current study was a prospective analytical study. Ninety patients between 1 month and 12 years old were included. A detailed medical history, clinical examination and on admission magnesium level were performed on all patients. The prognoses of the patients were evaluated by the length of PICU and hospital stay, the duration of mechanical ventilation and mortality.
Results: The mean concentration of magnesium level was 1.9±0.2 mg/dl; and 91.1% of patients were normomagnesemia and 5.6% were hypomagnesemia. The average duration of PICU stay in this study was about 8.1±3.8 days and the average duration of need for ventilator was 2.0±6.9 days. Only 18.9% of patients needed mechanical ventilation. Magnesium level was not correlated with PICU stay, need for mechanical ventilation, mortality and other electrolyte concentrations except for serum phosphorus.
Conclusion: The prevalence of hypomagnesaemia in pediatric patients admitted to the PICU is variable in different centers, so it is recommended that magnesium concentration levels be checked routinely and corrected if necessary.
Keywords
Hypomagnesemia
Magnesium
Pediatric Intensive Care Unit
Prognosis
  1. Lee JW. Fluid and electrolyte disturbances in critically ill patients. Electrolytes & Blood Pressure: E & BP. 2010 Dec;8(2):72.
  2. Kraft MD, Btaiche IF, Sacks GS, Kudsk KA. Treatment of electrolyte disorders in adult patients in the intensive care unit. American Journal of Health-System Pharmacy. 2005 Aug 15;62(16):1663-82.
  3. Buckley MS, LeBlanc JM, Cawley MJ. Electrolyte disturbances associated with commonly prescribed medications in the intensive care unit. Critical care medicine. 2010 Jun 1;38:S253-64.
  4. Sadeghi-Bojd S, Noori NM, Damani E, Teimouri A. Electrolyte disturbances in PICU: a cross sectional study. Nephro-Urology Monthly. 2019 May 31;11(2).
  5. Tong GM, Rude RK. Magnesium deficiency in critical illness. Journal of intensive care medicine. 2005 Jan;20(1):3-17.
  6. Escuela MP, Guerra M, Añón JM, Martínez-Vizcaíno V, Zapatero MD, García-Jalón A, Celaya S. Total and ionized serum magnesium in critically ill patients. Intensive care medicine. 2005 Jan;31:151-6.
  7. Safavi M, Honarmand A. Admission hypomagnesemia--impact on mortality or morbidity in critically ill patients. Middle East journal of anaesthesiology. 2007 Oct 1;19(3):645-60.
  8. Vormann J. Magnesium: nutrition and metabolism. Molecular aspects of medicine. 2003 Feb 6;24(1-3):27-37.
  9. Chandrashekhar C, Pillai R, Vasudev PH, Babu T, Panachiyil GM. A Prospective Observational Study of Hypomagnesemia in Critically Ill Paediatric Patients. Journal of Nepal Paediatric Society. 2020 Sep 11;40(2):67-71.
  10. Saleem AF, Haque A. On admission hypomagnesemia in critically ill children: Risk factors and outcome. The Indian Journal of Pediatrics. 2009 Dec;76:1227-30.
  11. Martin KJ, González EA, Slatopolsky E. Clinical consequences and management of hypomagnesemia. Journal of the American Society of Nephrology. 2009 Nov 1;20(11):2291-5.
  12. Singhi SC, Singh J, Prasad R. Hypo‐and Hypermagnesemia in an Indian Pediatric Intensive Care Unit. Journal of tropical pediatrics. 2003 Apr 1;49(2):99-103.
  13. Viering DH, de Baaij JH, Walsh SB, Kleta R, Bockenhauer D. Genetic causes of hypomagnesemia, a clinical overview. Pediatric nephrology. 2017 Jul;32:1123-35.
  14. Broman M, Hansson F, Klarin B. Analysis of hypo‐and hypermagnesemia in an intensive care unit cohort. Acta anaesthesiologica Scandinavica. 2018 May;62(5):648-57.
  15. Hulst JM, Joosten KF, Tibboel D, van Goudoever JB. Causes and consequences of inadequate substrate supply to pediatric ICU patients. Current Opinion in Clinical Nutrition & Metabolic Care. 2006 May 1;9(3):297-303.
  16. Dandinavar SF, Ratageri VH, Wari PK. Prevalence of hypomagnesemia in children admitted to pediatric intensive care unit and its correlation with patient outcome. International Journal of Contemporary Pediatrics. 2019. 6(2):462-467.
  17. Assarian A, Noormandi A, Khalili H, Mohammadi M, Abdollahi A. Correlation between Serum Magnesium and Lactate Levels at the Time of ICU Admission and Early Phase of Sepsis. Archives of Anesthesiology and Critical Care. 2019 Jul 2;5(3):86-90.
  18. 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 May 1;9(5):13539-49.
  19. Peivandi 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.
  20. Gragossian A, Bashir K, Bhutta BS, Friede R. Hypomagnesemia.
  21. Farrukh RI, Masood SH, Shakoor I, Naseer AM, Sultana SA, Nasir F. Outcome and Incidence of Hypomagnesemia in Children Admitted in Pediatric Intensive Care Unit of a Tertiary Care Hospital. Pakistan Journal of Medical and Health Sciences. 2021;15(5):1169-73.
  22. Erdogan I, Gursu HA, Varan B, Ozkan M, Sezgin A. Hypomagnesemia in pediatric heart transplant patients treated with tacrolimus. Exp. Clin. Transplant. 2016;10.
  23. Soliman HM, Mercan D, Lobo SS, Mélot C, Vincent JL. Development of ionized hypomagnesemia is associated with higher mortality rates. Critical care medicine. 2003 Apr 1;31(4):1082-7.
  24. Valizadeh Hassanlouei MA, Hassani E, Rahimi Rad MH, Adeli SH, Karimi Sakhvidi N, Boudag H. Evaluation of serum magnesium and the effect on prognosis in patients admitted to intensive care unit. Studies in Medical Sciences. 2013 Apr 10;24(1):30-7.
  25. Honarmand AZ, Safavi MR. Association between admission hypomagnesemia mortality or mortality of critically ill patients in intensive care unit. Hormozgan Med J. 2008 Jan 1;12(3):151-60.
  26. Limaye CS, Londhey VA, Nadkart MY, Borges NE. Hypomagnesemia in critically ill medical patients. The Journal of the Association of Physicians of India. 2011 Jan 1;59:19-22.
  27. Karnik ND, Gupta AV. Hypomagnesemia in ICU. The Journal of the Association of Physicians of India. 2016 Nov;64(11):11-3.
Journal of Pediatric Perspectives
Volume 12, Issue 8
August 2024
Pages 18946-18952