Jiang Pan, Lv Qiurong, Lai Tianwen, Xu Feng
*Department of Stomatology, The Third People Hospital of Hainan Province, Sanya, China †Department of Ophthalmology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, China ‡Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, China §Department of Respiratory and Critical Care Medicine, The Third People Hospital of Hainan Province, Sanya, China.
Shock. 2017 Mar;47(3):288-295. doi: 10.1097/SHK.0000000000000769.
Hypomagnesemia is commonly seen but frequently overlooked in critically ill patients in intensive care unit (ICU). However, the strength and consistency of the effect of hypomagnesemia on outcomes in critically ill patients remain controversial. In this report, we performed a systematic review and meta-analysis to evaluate the association of serum magnesium level with prognosis of critically ill patients upon admission to the ICU. A comprehensive search for clinical trials was performed, and 10 studies comprising 1,122 cases and 630 controls were finally selected for analysis. The patients with hypomagnesemia had higher mortality rate (risk ratio [RR] 1.76; 95% confidence interval [CI] 1.54-2.00; P <0.00001), more frequently had sepsis (RR 2.04; 95% CI 1.21-3.42; P = 0.0007) and more frequent need for ventilatory support (RR 1.36; 95% CI 1.21 to 1.53; P <0.00001). Length of ICU stay was also higher in the hypomagnesemia group (RR 1.85; 95% CI 0.43- 3.26; P = 0.01). Collectively, our data indicated that hypomagnesemia appears associated with greater risk of mortality, sepsis, mechanical ventilation, and the length of ICU stay in patients admitted to ICU. The role of magnesium therapy for improving outcomes in critically ill patients is needed to further study.
低镁血症在重症监护病房(ICU)的重症患者中很常见,但经常被忽视。然而,低镁血症对重症患者预后影响的强度和一致性仍存在争议。在本报告中,我们进行了一项系统评价和荟萃分析,以评估血清镁水平与ICU入院时重症患者预后的相关性。我们对临床试验进行了全面检索,最终选择了10项研究,共1122例病例和630例对照进行分析。低镁血症患者的死亡率更高(风险比[RR]1.76;95%置信区间[CI]1.54 - 2.00;P<0.00001),更频繁发生脓毒症(RR 2.04;95%CI 1.21 - 3.42;P = 0.0007),更频繁需要通气支持(RR 1.36;95%CI 1.21至1.53;P<0.00001)。低镁血症组的ICU住院时间也更长(RR 1.85;95%CI 0.43 - 3.26;P = 0.01)。总体而言,我们的数据表明,低镁血症似乎与ICU入院患者的死亡、脓毒症、机械通气风险增加以及ICU住院时间延长有关。镁治疗对改善重症患者预后的作用需要进一步研究。