Investigating The Agreement of Hypomagnesemia Diagnosis in Three Perimeter of Serum, Urine, and Red Blood Cell in Intensive Care Unit: Pilot Study

Nastaran  Nazarzade; Mojtaba  Mojtahedzadeh; Farshid  Gholami; Amirmahdi  Mojtahedzadeh; Maryam  Shiehmorteza; Amirhossein  Ghanbarzamani

doi:10.18502/aacc.v11i1.17490

Nastaran Nazarzade Department of Clinical Pharmacy, Faculty of Pharmacy, Islamic Azad University, Pharmaceutical Sciences Branch, Tehran, Iran.
Mojtaba Mojtahedzadeh Faculty of Pharmacy and Pharmaceutical Science Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Farshid Gholami Department of Anesthesiology, Booali Hospital, Islamic Azad University, Tehran medical Branch, Tehran, Iran.
Amirmahdi Mojtahedzadeh Faculty of Medicine, Semmelweis University, Budapest, Hungary.
Maryam Shiehmorteza Department of Clinical Pharmacy, Faculty of Pharmacy, Islamic Azad University, Pharmaceutical Sciences Branch, Tehran, Iran.
Amirhossein Ghanbarzamani Department of Clinical Pharmacy, Faculty of Pharmacy, Islamic Azad University, Pharmaceutical Sciences Branch, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v11i1.17490

Keywords: Hypomagnesemia; Serum magnesium; RBC magnesium; Urine magnesium; Intensive care unit

Abstract

Background: Magnesium is a vital element in the body involved in biochemical and physiological processes. Magnesium deficiency can lead to serious consequences including cardiac, neurological, muscular disorders, and other clinical manifestations. In our country, commonly, magnesium measurement is done by measuring serum magnesium levels. This paper discusses the prevalence and consequences of magnesium deficiency in patients hospitalized in the ICU and emphasizes the importance of diagnosis and treating hypomagnesemia.

Methods: Diagnosis of hypomagnesemia is done by measuring serum magnesium, urine magnesium, and magnesium in RBCs. We conducted a prospective study on 30 critically ill patients (14 male, and 16 female) who were admitted to the ICU to examine the prevalence of magnesium deficiency. In eligible patients, after measuring serum and RBC magnesium levels, 7.5 grams of magnesium sulfate in 1000 ml isotonic saline was infused over 8 hours at a rate of 125 ml/hour and urine was collected for 24 hours from the start of the infusion.

Results: The mean age was 71. There was a significant difference between the levels of serum Mg and RBC Mg (U statistic = 266 and P<0.05). The results showed a significant difference between the levels of serum Mg and urinary Mg (U statistic was almost 0 and P<0.05). The results indicated a significant difference between the levels of urinary Mg and RBC Mg (U statistic was almost 0 and P<0.05).

Conclusion: There is no correlation between serum magnesium and the body’s magnesium requirement in patients, and serum magnesium does not reflect the actual status of patients in the ICU. Therefore, measuring the level of magnesium in red blood cells is preferable to urinary magnesium and serum magnesium to investigate hypomagnesemia in the ICU. Additionally, there is no correlation between age, gender, APACHE II score, and the percentage of infused magnesium absorption in patients.