IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 18, Issue 12 Ser.4 (December. 2019), PP 17-21 www.iosrjournals.org DOI: 10.9790/0853-1812041721 www.iosrjournals.org 17 | Page A Prospective Observational Study of Serum Magnesium Levels in Critically Ill Patients Dr.V.K.Sinha 1* 1* Associate Professor, Department of General Medicine, M.G.M Medical College, Jamshedpur, Jharkhand. Corresponding Author: Dr.V.K.Sinha Abstract: Introduction: Magnesium is fourth most common cat ion in the body and second most common intracellular cat ion after potassium, yet its deficiency in critically ill patients is frequently overlooked. Various studies have reported the incidence of hypomagnesemia up to 65% in critically ill-patients. Materials and Methods: This observational study was conducted in the Department of Medicine, M.G.M Medical College, Jamshedpur among the critically ill patients admitted in MICU and ICCU from January 2018 to December 2018. Ethical clearance was obtained and the study was initiated. Patients were selected based on the inclusion criteria. Written informed consent was taken from all the patients. A complete history, physical examination and systemic examination was done in all the patients. Amongst patients who fulfilled the inclusion criteria, 5 mL of venous blood was taken at the time of hospital admission for blood investigations and other routine examinations. Patient’s baseline information was recorded at admissi on including age, sex, blood pressure (in mmHg), and random glucose level at admission (in mg/dL). Results: At admission, the incidence of hypomagnesaemia was 52.6%;27.3% patients had hypermagnesaemia, while 20% patients had normomagnesaemia. A significantly higher APACHE II Score was recorded in subjects with hypomagnesaemia compared to those with normomagnesaemia. Hyponatraemia was seen in 76% patients, while 29.4% patients had hypocalcaemia and 44.2% had hypokalaemia. Length of ICU stay was found to be significantly higher in subjects with hypomagnesaemia compared to those with normomagnesaemia and hypermagnesaemia (p<0.0001). Mortality was higher in patients with hypomagnesaemia (80%), while that in the hypermagnesaemia group had 53.8% mortality. Conclusion: This study revealed the prevalence of dysmagnesaemia in the critically ill population of ICU and highlighted the role of magnesium monitoring. This study also showed that hypomagnesaemia was associated with higher APACHE II score, longer ICU stay and greater mortality. Key Words: Magnesium; Hypomagnesaemia; Critical Illness; Mortality; Dysmagnesaemia. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 27-11-2019 Date of Acceptance: 12-12-2019 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Magnesium is fourth most common cat ion in the body and second most common intracellular cat ion after potassium, yet its deficiency in critically ill patients is frequently overlooked. Various studies have reported the incidence of hypomagnesemia up to 65% in critically ill-patients. 1 Although many paradigms have been explored to minimize the mortality in critical care units, magnesium loss has been scarcely addressed; in this respect leading to inconclusive results. 2 Serum magnesium monitoring may have prognostic and perhaps therapeutic implications because critically ill-patients are predisposed to both symptomatic or asymptomatic magnesium deficiency that can lead to some important clinical consequences (such as hypokalemia, cardiac arrhythmias, hypocalcemia, neurotoxicity and psychiatric problems), ultimately increasing the morbidity and mortality. 3 There is a paucity of data in Indian literature, addressing this common, but under diagnosed electrolyte deficiency. Present study was undertaken against this backdrop at a tertiary care teaching hospital to assess the magnitude of magnesium deficiency and its influence on the outcome of critically ill-patients so that baseline reference data for insight and management of the problem in routine cases in our intensive care units (ICUs) is formed. 4 II. Materials And Methods This observational study was conducted in the Department of Medicine, M.G.M Medical College, Jamshedpur among the critically ill patients admitted in MICU and ICCU from January 2018 to December 2018. Ethical clearance was obtained and the study was initiated. Patients were selected based on the inclusion criteria. Written informed consent was taken from all the patients. A complete history, physical examination and systemic examination was done in all the patients. Amongst patients who fulfilled the inclusion criteria, 5 mL of