Krupesh Vijay Raju, Varayathu Hrishi, Sarathy Vinu, Rao Gogana Prabhakar, Shrestha Yogendra, Naik Radheshyam
Healthcare Global Enterprises Limited, Sampangi Ram Nagar, Bangalore 560027, India.
Mol Clin Oncol. 2021 Jun;14(6):123. doi: 10.3892/mco.2021.2285. Epub 2021 Apr 21.
Hypermagnesemia is often an under reported finding in critically ill patients with cancer. Hypomagnesemia is a commonly encountered electrolyte abnormality in patients with cancer that is primarily caused by a reduced intake, secondary to chemotherapeutic drugs and malnutrition. Hypermagnesemia is rarely observed in patients with normal renal function, as excess intake can be compensated by renal excretion. However, in critically ill patients with reduced renal function, hypermagnesemia can add further to complications and increase mortality. Drugs such as lactulose, antacids, fentanyl and peptide hormones, including vasopressin, can further increase chances of hypermagnesemia, particularly when patients demonstrate decreased renal function and multiple organ failure. Prudence and caution must therefore be exercised while using these agents in critically ill patients with cancer to avoid increased complications and mortality. Herein, the current study reports three cases of critically ill patients with cancer admitted into intensive care who had refractory hypermagnesemia.
高镁血症在重症癌症患者中常常是一个报告不足的发现。低镁血症是癌症患者中常见的电解质异常，主要由摄入减少引起，继发于化疗药物和营养不良。肾功能正常的患者很少观察到高镁血症，因为过量摄入可通过肾脏排泄得到代偿。然而，在肾功能减退的重症患者中，高镁血症会进一步增加并发症并提高死亡率。乳果糖、抗酸剂、芬太尼以及包括血管加压素在内的肽类激素等药物会进一步增加高镁血症的发生几率，尤其是当患者出现肾功能减退和多器官功能衰竭时。因此，在癌症重症患者中使用这些药物时必须谨慎小心，以避免并发症增加和死亡率上升。在此，本研究报告了三例入住重症监护病房的癌症重症患者，他们患有难治性高镁血症。
