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YOĞUN BAKIM ÜNİTESİNDE SERUM MAGNEZYUM DÜZEYİ DEĞERLENDİRİLMELİ Mİ?

Year 2014, Volume: 28 Issue: 3, 155 - 159, 01.12.2014

Abstract

Amaç: Elektrolit dengesizlikleri yoğun bakım hastalarında sıklıkla görülür. Hipomagnezemi yeterince tanımlanmamakla birlikte YBÜ mortalitesine katkıda bulunabilir. Bu çalışmanın amacı kritik hastalarda hipomagnezemi sıklığını saptamak ve mekanik ventilasyon günü, YBÜ'de kalış süresi ve mortalite ile ilişkisini saptamayı amaçladık. Yöntem ve Gereç: Ocak 2008-Temmuz 2008 arasında solunum yetmezliği ile YBÜ'ne başvuran 60 hasta alındı. Prospektif çalışmada başvuru sırasında hastaların serum total Mg düzeyi, elektrolit düzeyleri, total protein, albumin ve laktat düzeyi ölçüldü. Hastaların demografik özellikleri, eşlik eden nörolojik ve kardiyak bulguları, APACHE II skoru, mekanik ventilasyon süresi, YBÜ‘de kalış süresi ve mortalite oranı kaydedildi. Bulgular: Hastaların % 27'sinde başvuru sırasında hipomagnezemi saptandı. Serum Mg ile Ca düzeyleri arasında pozitif korelasyon bulundu (p=0.03), ancak diğer laboratuar testleri arasında ilişki saptanmadı. Hipomagnezemi ile mekanik ventilasyon süresi, YBÜ‘de kalış süresi ve mortalite oranı arasında ilişki saptanmadı (p>0.05). Sonuç: Elektrolit düzeylerinin monitorizasyonu kritik hastalarda önemlidir. Ancak Mg düzeyinin rutin ölçülmesinden ziyade, hipomagnezemiye ait klinik bulguları olan hastalarda Mg düzeyinin ölçülmesinin uygun olacağı görüşündeyiz.

References

  • 1. DubeL, Granry JC.The Therapeutic Use of Magnesium in Anesthesiology, Intensive Careand Emergency Medicine: AReview. Can J Anesth 2003; 50(7): 732-46.
  • 2. DelhumeauA, Granry JC. Indicationsfor The Use of Magnesium in Anesthesia and Intensive Care. Ann Fr Anesth Reanim 1995; 1485): 406-16.
  • 3. Berkelhammer C, Bear RA. A clinicalapproachto comm. One lectrolyte problems: 4. Hypomagnesemia. Can Med Assoc J. 1985; 132(4): 360-8.
  • 4. Connolly E, Worthley L. I. G. Intravenous magnesium. Critical Careand Resuscitation 1999; 1: 162-72.
  • 5. Ryzen E, WagersPW,Singer FR, Rude RK. Magnesiumdeficiency in a medical ICU population. CritCareMed 1985; 13: 19-21.
  • 6. Rubeiz GJ, Thill- Baharozian M,Hardie D, Carlson RW. Associationof hypo magnesemia and mortality in acutelyillmedicalpatients. Crit Care Med 1993; 21: 203-9.
  • 7. Tong GM, RudeRK. Magnesium deficiency in criticalillness. J Intensive Care Med 2005; 20(1): 3- 17.
  • 8. Limaye CS,LondheyVA,NadkarMY,Borges NE. Hypomagnesemia in Critically Ill Medical Patients. JAPI 2011; Vol 59: 19-22.
  • 9. Croker JW, Walmsley RN. Routine plasma magnesiu mestimation: auseful test? Med J Aust. 1986; 145(2): 74-6.
  • 10. Verive MJ, Irazuzta J. Evaluatingt hefrequency rate of hypomagnesemia in criticall yillpediatricpatientsbyusingmultipleregessionanalysisand a computer-based neuralnetwork. CritCare Med 2000; 28(10): 3534-9.
  • 11. Ryzen E. Magnesiumhomeostasis in criticallyillpatients. Magnesium 1989; 8(3-4): 201-12.
  • 12. Guerin C, Cousin, Mignot F. Serumanderythrocyte magnesium in criticallyillpatients. Intensive Care Med 1996; 22(8): 724-7.
  • 13. Reinhart RA, Desbiens NA. Hypo magnesemia in patient senteringthe ICU. Crit Care Med 1985; 13(6):506-7.
  • 14. Elin RJ. Magnesium metabolism in healthanddisease. Dis Mon 1988; 34(4):161-218.
  • 15. Huijgen HJ, Soesan M, Sanders R. Magnesium levels in criticallyill patients. What should wemeasure? Am J ClinPathol 2000; 114:688- 95.
  • 16. Arnold A, Tovey J. Magnesium deficiency in critically illpatients. Anaesthesia 1995; 50(3): 203-5.
  • 17. Fiaccadori E, Del Canale S .Muscleand serum magnesium in pulmonary intensive care unit patients. Crit Care Med 1988; 16(8): 751-60.
  • 18. Escuela MP, Guerra M. Totalandionized serum magnesium in criticallyill patients. Intensive Care Med 2005; 31(1): 151-6.
  • 19. Soliman HM, MercanD.Development of ionized hypomagnesemia is associated with higher mortality rates. Crit Care Med 2003; 31(4): 1082-7.
  • 20. Safavi M,Honarmand A. Admission hypomagnesemia-impact on mortalityormorbidity in criticallyill patients. Middle East Anesthesiol 2007; 19(3): 645-60.

SHOULD SERUM MAGNESIUM LEVELS BE EVALUATED IN INTENSIVE CARE UNIT?

Year 2014, Volume: 28 Issue: 3, 155 - 159, 01.12.2014

Abstract

Aim: Electrolyte disturbances are often seen in patients in intensive care unit (ICU). Hypomagnesemia is not enough discribed but can be contributed in ICU mortality.The aim of this study was to define the prevalance of hypomagnesemia in critically ill patients and to evaluate its relationship with duration of mechanical ventilation day, length of ICU stay, and mortality. Material and Methods: A prospective study was done on 60 patients with respiratory failure admitted to the ICU between January 2008 and July 2008. Total serum magnesium (Mg) level, electrolyte levels, albumin, total protein, and lactate levels were evaluated at the admission. Patients demographic features, accompanying neurological and cardiac symptoms, Acute Physiology and Chronic Health Evaluation (APACHE II) score, duration of mechanical ventilation, and the length of ICU stay and mortality were recorded. Results: At admission 27% of patients had hypomagnesemia. A positive correlation was found between serum Mg and calcium (Ca) level (p=0.03), but there was no relationship between other laboratory tests. Also there was no relationship determined between hypomagnesemia and duration of mechanical ventilation,and the length of ICU stay and mortality (p>0.05). Conclusion: Monitoring of electrolyte levels is important in critically ill patients.However the routine measurement of the level of serum Mg rather than the measurement of the level of Mg in patients with clinical signs of hypomagnesemia believe to be appropriate.

References

  • 1. DubeL, Granry JC.The Therapeutic Use of Magnesium in Anesthesiology, Intensive Careand Emergency Medicine: AReview. Can J Anesth 2003; 50(7): 732-46.
  • 2. DelhumeauA, Granry JC. Indicationsfor The Use of Magnesium in Anesthesia and Intensive Care. Ann Fr Anesth Reanim 1995; 1485): 406-16.
  • 3. Berkelhammer C, Bear RA. A clinicalapproachto comm. One lectrolyte problems: 4. Hypomagnesemia. Can Med Assoc J. 1985; 132(4): 360-8.
  • 4. Connolly E, Worthley L. I. G. Intravenous magnesium. Critical Careand Resuscitation 1999; 1: 162-72.
  • 5. Ryzen E, WagersPW,Singer FR, Rude RK. Magnesiumdeficiency in a medical ICU population. CritCareMed 1985; 13: 19-21.
  • 6. Rubeiz GJ, Thill- Baharozian M,Hardie D, Carlson RW. Associationof hypo magnesemia and mortality in acutelyillmedicalpatients. Crit Care Med 1993; 21: 203-9.
  • 7. Tong GM, RudeRK. Magnesium deficiency in criticalillness. J Intensive Care Med 2005; 20(1): 3- 17.
  • 8. Limaye CS,LondheyVA,NadkarMY,Borges NE. Hypomagnesemia in Critically Ill Medical Patients. JAPI 2011; Vol 59: 19-22.
  • 9. Croker JW, Walmsley RN. Routine plasma magnesiu mestimation: auseful test? Med J Aust. 1986; 145(2): 74-6.
  • 10. Verive MJ, Irazuzta J. Evaluatingt hefrequency rate of hypomagnesemia in criticall yillpediatricpatientsbyusingmultipleregessionanalysisand a computer-based neuralnetwork. CritCare Med 2000; 28(10): 3534-9.
  • 11. Ryzen E. Magnesiumhomeostasis in criticallyillpatients. Magnesium 1989; 8(3-4): 201-12.
  • 12. Guerin C, Cousin, Mignot F. Serumanderythrocyte magnesium in criticallyillpatients. Intensive Care Med 1996; 22(8): 724-7.
  • 13. Reinhart RA, Desbiens NA. Hypo magnesemia in patient senteringthe ICU. Crit Care Med 1985; 13(6):506-7.
  • 14. Elin RJ. Magnesium metabolism in healthanddisease. Dis Mon 1988; 34(4):161-218.
  • 15. Huijgen HJ, Soesan M, Sanders R. Magnesium levels in criticallyill patients. What should wemeasure? Am J ClinPathol 2000; 114:688- 95.
  • 16. Arnold A, Tovey J. Magnesium deficiency in critically illpatients. Anaesthesia 1995; 50(3): 203-5.
  • 17. Fiaccadori E, Del Canale S .Muscleand serum magnesium in pulmonary intensive care unit patients. Crit Care Med 1988; 16(8): 751-60.
  • 18. Escuela MP, Guerra M. Totalandionized serum magnesium in criticallyill patients. Intensive Care Med 2005; 31(1): 151-6.
  • 19. Soliman HM, MercanD.Development of ionized hypomagnesemia is associated with higher mortality rates. Crit Care Med 2003; 31(4): 1082-7.
  • 20. Safavi M,Honarmand A. Admission hypomagnesemia-impact on mortalityormorbidity in criticallyill patients. Middle East Anesthesiol 2007; 19(3): 645-60.
There are 20 citations in total.

Details

Other ID JA27DA49HN
Journal Section Research Article
Authors

Özlem Ediboğlu This is me

Pınar Çimen This is me

Dursun Tatar This is me

Canan Doğan This is me

Gülru Polat This is me

Ceyda Anar This is me

Defne Özbek This is me

Publication Date December 1, 2014
Published in Issue Year 2014 Volume: 28 Issue: 3

Cite

APA Ediboğlu, Ö., Çimen, P., Tatar, D., Doğan, C., et al. (2014). YOĞUN BAKIM ÜNİTESİNDE SERUM MAGNEZYUM DÜZEYİ DEĞERLENDİRİLMELİ Mİ?. İzmir Göğüs Hastanesi Dergisi, 28(3), 155-159.