Controlling magnesium in surgery, intensive care, and beyond

In addition to the biochemical and physiological importance of magnesium, the increasing number of conditions associated with magnesium depletion, such as drug therapy and stress from surgery or trauma, have contributed toward increasing the clinical importance of detecting and correcting blood levels of magnesium. Orders for serum magnesium testing at our hospital have had astounding increases over the last 20 to 25 years, with more than 125,000 total magnesium measurements ordered in 2005. This report will cover recent findings in the following areas: • regulation of blood levels of magnesium; • the frequency of hypomagnesemia in critical care settings such as the intensive care unit and emergency department, in major surgery, and in metabolic disorders such as diabetes; • the cardiovascular and metabolic effects of magnesium depletion, such as arrhythmias, vasoconstriction, inflammation, hypercoagulability, insulin resistance, and electrolyte disturbances; and • the clinical benefits of magnesium supplementation in various settings. The diagnosis of magnesium deficiency will also be discussed with reference to total and ionized magnesium in blood, the magnesium retention test, and the role of a possible biomarker for detecting magnesium deficiency. © 2007 Lippincott Williams & Wilkins, Inc.

Duke Scholars

Author John Griffith Toffaletti Pathology