Department of General Medicine, MS Ramaiah Medical College, Bengaluru, India.
Kathmandu Univ Med J (KUMJ). 2023 Jan-Mar;21(81):23-27.
Background Magnesium plays an important role in sepsis, and this could be attributed to its effects on the immune system, which are important in the pathogenesis of sepsis. Magnesium deficiency, one of the underrated electrolyte abnormalities, is observed in critically ill patients admitted to intensive care unit (ICU). Objective To find the association of serum magnesium with the outcome, duration, and need for ventilation. Method The hospital-based prospective observational study included patients > 18 years (N=150) with sepsis admitted to intensive care unit. Patients were divided into normomagnesemia (n=75) and hypomagnesemia (n=75) groups. Sequential Organ Failure Assessment Score (SOFA) score, length of intensive care unit stay, need and duration of mechanical ventilatory requirement, and outcomes were compared between the two groups. Result The mean Sequential Organ Failure Assessment score (5.87 ± 2.31 vs. 3.85 ± 1.75), mean duration of intensive care unit stay (in days) (7.21 ± 1.74 vs. 5.24 ± 1.38), the mean duration of mechanical ventilatory requirement (in days) (4.05 ± 3.47 vs. 1.13 ± 1.98), and mortality rate were (33% vs. 4%) were higher in the hypomagnesemia group when compared to the normomagnesemia group (p < 0.001 for all). Conclusion The study concludes that hypomagnesaemia is a significant electrolyte abnormality in critically ill sepsis patients. Hypomagnesaemia, Sequential Organ Failure Assessment Score, and mechanical ventilation are the factors that independently predicted mortality in intensive care unit patients. Hence, clinicians should regularly monitor the occurrence of hypomagnesemia in intensive care unit patients to reduce its poor clinical outcomes.
镁在脓毒症中起着重要作用，这可能归因于其对免疫系统的影响，而免疫系统在脓毒症的发病机制中很重要。镁缺乏是一种被低估的电解质异常，在入住重症监护病房（ICU）的危重病患者中很常见。目的：探讨血清镁与预后、持续时间和通气需求的关系。方法：本研究为医院前瞻性观察性研究，纳入 150 例年龄＞18 岁的脓毒症患者。患者分为正常镁血症组（n=75）和低镁血症组（n=75）。比较两组患者的序贯器官衰竭评估（SOFA）评分、入住 ICU 的时间、机械通气的需求和持续时间以及结局。结果：低镁血症组的平均 SOFA 评分（5.87±2.31 vs. 3.85±1.75）、入住 ICU 的时间（7.21±1.74 vs. 5.24±1.38）、机械通气时间（4.05±3.47 vs. 1.13±1.98）和死亡率（33% vs. 4%）均高于正常镁血症组（均 p＜0.001）。结论：低镁血症是危重症脓毒症患者的一种显著电解质异常。低镁血症、SOFA 评分和机械通气是 ICU 患者死亡的独立预测因素。因此，临床医生应定期监测 ICU 患者低镁血症的发生，以降低其不良临床结局。
