YOĞUN BAKIM ÜNİTESİNDE SERUM MAGNEZYUM DÜZEYİ DEĞERLENDİRİLMELİ Mİ?

Öz

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.

Anahtar Kelimeler

• Magnezyum, yoğun bakım ünitesi, mortalite

SHOULD SERUM MAGNESIUM LEVELS BE EVALUATED IN INTENSIVE CARE UNIT?

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.

Keywords

• Magnesium, intensive care unit, mortality

Kaynakça

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