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  • Title: Ionized magnesium concentrations in critically ill children.
    Author: Fiser RT, Torres A, Butch AW, Valentine JL.
    Journal: Crit Care Med; 1998 Dec; 26(12):2048-52. PubMed ID: 9875919.
    Abstract:
    OBJECTIVE: To test the hypothesis that many critically ill children exhibit ionized hypomagnesemia despite having normal total magnesium (TMg) concentrations. DESIGN: A prospective, observational study with convenience sampling. SETTING: Pediatric and cardiovascular intensive care units of a large children's hospital. PATIENTS: Patients aged 1 day to 21 yrs admitted from January 1 to October 31, 1996. Patients with chronic renal failure or weight <3 kg were excluded. A group of healthy children involved in a school-based nutritional assessment study were also studied. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Sixty-seven patients (5.4+/-5.7 [SD] yrs) and 24 healthy children (10.84+/-0.93 yrs, p< .001) were studied. Plasma was assayed for ionized magnesium (IMg) using a blood analyzer. Forty (59%)/67 critically ill subjects had IMg concentrations <0.40 mmol/L, the lowest published normal value and the lowest value observed in our group of healthy children. Of these, 24 (60%)/40 had normal TMg concentrations. IMg was significantly (p=.00) lower in critically ill subjects than in the group of healthy children (0.37+/-0.10 mmol/L vs. 0.46+/-0.03 mmol/L). IMg did not correlate strongly with ionized calcium (r2=0.49), albumin (r2=0.09), or pH (r2=0.18). CONCLUSION: Many critically ill children exhibit ionized hypomagnesemia with normal TMg concentrations. These children would not be recognized as magnesium-deficient based on routine TMg testing. Critically ill children exhibited significantly lower concentrations of IMg than a group of healthy children.
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