Stanojević Marija B, Parezanovic Miro, Biorac Marko, Spasić Svetolik, Kovačević Sanjin, Lopičić Srđan, Nešović Ostojić Jelena
University of Belgrade, Faculty of Medicine, Institute for Pathological Physiology "Ljubodrag Buba Mihailović", Belgrade.
Institute for Mother and Child Healthcare of Serbia "Dr Vukan Čupić", Belgrade.
J Med Biochem. 2025 Jun 13;44(3):386-399. doi: 10.5937/jomb0-54782.
Critical illnesses imply vital organ dysfunctions with high risk of imminent death. Magnesium is a bioessential element with multiple physiological effects relevant for vital body functions. It stabilizes excitable membranes contributing to proper neuromuscular, cardiovascular and respiratory functions. Ionized Mg2+ (iMg2+) is free bioactive form of Mg2+ in body fluids. Magnesium disorders in critically ill patients are often overlooked. Chronic Mg2+ deficiency is a condition of growing incidence in the general population and a significant factor in overall morbidity and mortality in critical illness. Main goal of this study was to investigate the existing literature related to determination of iMg2+ in the critically ill and to raise awareness of the problem of chronic Mg2+ deficiency in these patients.
Search was conducted across electronic PubMed library database from 1975 to November 2024 using keywords concerning iMg2+ and critical care patients, to identify studies investigating the measuring of blood concentration of iMg2+ fraction in patients with critical health conditions. Search was limited to English language. Selection criteria included only studies on human, and excluded studies on animal population.
We identified 95 relevant studies. Reviewed papers show that abnormalities of Mg2+ levels are prevalent in critical illnesses. Their severity can impose vital threat. Disconcordance between total Mg2+ (tMg2+) and iMg2+ blood levels is frequently present in critical patients.
Appropriate electrolyte analyzer assay is needed to promptly determine iMg2+ levels to assess Mg2+ status in critically ill patients, in order to help detect and correct Mg2+ imbalances and estimate the requirement for Mg2+ recompense in the case of deficiency, and thereby provide better outcome of the disease.
危重病意味着重要器官功能障碍，死亡风险极高。镁是一种对维持身体重要功能具有多种生理作用的生物必需元素。它能稳定可兴奋膜，有助于正常的神经肌肉、心血管和呼吸功能。离子化镁（iMg2+）是体液中镁的游离生物活性形式。危重病患者的镁紊乱常常被忽视。慢性镁缺乏在普通人群中的发病率呈上升趋势，是危重病总体发病率和死亡率的一个重要因素。本研究的主要目的是调查与危重病患者iMg2+测定相关的现有文献，并提高对这些患者慢性镁缺乏问题的认识。
在1975年至2024年11月期间，通过电子PubMed图书馆数据库进行检索，使用与iMg2+和重症监护患者相关的关键词，以识别研究危重病患者血液中iMg2+分数浓度测量的研究。检索仅限于英文文献。选择标准仅包括关于人类的研究，排除关于动物群体的研究。
我们识别出95项相关研究。综述论文表明，镁水平异常在危重病中很普遍。其严重程度可能构成生命威胁。危重病患者中总镁（tMg2+）和iMg2+血液水平之间经常存在不一致。
需要使用合适的电解质分析仪检测方法来及时测定iMg2+水平，以评估危重病患者的镁状态，从而有助于检测和纠正镁失衡，并在缺乏镁的情况下估计镁补充的需求，进而改善疾病预后。
