Department of Intensive Care, Rigshospitalet University of Copenhagen, Copenhagen, Denmark.
Department of Critical Care, King's College London, Guy's & St Thomas' Hospital, London, UK.
Acta Anaesthesiol Scand. 2021 Mar;65(3):390-396. doi: 10.1111/aas.13738. Epub 2020 Nov 25.
Patients admitted to the Intensive Care Unit (ICU) often have low magnesium, phosphate and zinc levels. Monitoring of serum concentrations and supplementation may be important, but there is no consensus on optimal practice. The objective of the WhyTrace survey was to describe current practice regarding the measurement and supplementation of magnesium, phosphate and zinc in ICUs.
A 54-item electronic questionnaire was developed in accordance with SURGE, SUrvey Reporting GuidelinE, to address international clinical practice in the ICU. National investigators recruited ICUs in ten countries with one physician responding per ICU using a unique e-mail distributed survey-link.
The questionnaire was sent to clinicians in 336 ICUs of whom 283 (84%) responded. In 62% of the ICUs, a standard procedure was in place regarding the measurement of serum magnesium levels, in 58% for phosphate and in 9% for zinc. Zinc was never or rarely measured in 64% of ICUs. The frequency of requesting serum levels varied from twice daily to once weekly. Regarding supplementation, 66% of ICUs had a standard procedure for magnesium, 63% for phosphate and 15% for zinc. Most procedures recommended supplementation when serum levels were below the lower reference level, but some used the upper reference levels as the threshold for supplementation and others decided on a case-by-case basis.
The practice of measuring and supplementing magnesium, phosphate and zinc differed substantially between ICUs. Our findings indicate that there is a need for high-quality prospective data on frequencies of measurements, treatment goals and effects of supplementation on patient-important outcomes.
入住重症监护病房（ICU）的患者常伴有低镁、低磷和低锌血症。监测血清浓度并进行补充可能很重要，但目前尚无关于最佳实践的共识。WhyTrace 调查的目的是描述 ICU 中镁、磷和锌的测量和补充的当前实践情况。
根据 SURGE（调查报告指南）制定了 54 项电子问卷，以解决 ICU 中的国际临床实践问题。10 个国家的国家调查人员招募了 ICU，每个 ICU 由一名医生使用分发的唯一电子邮件调查链接进行回复。
该问卷发送给了 336 个 ICU 的临床医生，其中 283 名（84%）做出了回应。在 62%的 ICU 中，有标准程序用于测量血清镁水平，58%用于测量磷，9%用于测量锌。64%的 ICU 从不或很少测量锌。请求血清水平的频率从每天两次到每周一次不等。关于补充，66%的 ICU 有镁的标准程序，63%的 ICU 有磷的标准程序，15%的 ICU 有锌的标准程序。大多数程序建议在血清水平低于下限时进行补充，但有些程序使用上限作为补充的阈值，而其他程序则根据具体情况决定。
各 ICU 之间测量和补充镁、磷和锌的实践存在很大差异。我们的研究结果表明，需要高质量的前瞻性数据来了解测量频率、治疗目标以及补充对患者重要结局的影响。
