Skip to main content
SpringerLink
Log in

Magnesium in critical illness: metabolism, assessment, and treatment

  • Chapter
  • First Online:
Applied Physiology in Intensive Care Medicine

  • 2489 Accesses

Abstract

Magnesium is the second most abundant intracellular cation and the fourth most common cation in the body [1]. Its importance as an essential nutrient has been recognized since 1932, when Kruse et al. [2] reported the effects of acute Mg deficiency in rats. Even recently Mg was considered the “forgotten cation” in clinical practice [3]; however, this is no longer the case [4]. Estimates of Mg deficiency range from 20% to 61% [5, 6, 7], while a recent study found that reductions in total serum Mg on admission are associated with increased mortality [8].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Elin RJ (1994) Magnesium: the fifth but forgotten electrolyte. Clin Chem 102:616–622

    CAS  Google Scholar 

  2. Kruse HD, Orent ER, McCollum EV (1932) Studies on magnesium deficiency in animals. I. Symptomatology resulting from Mg deprivation. J Biol Chem 96:519–539

    Google Scholar 

  3. Whang R (1987) Routine serum magnesium determination: a continuing unrecognized need. Magnesium 6:1–4

    PubMed  CAS  Google Scholar 

  4. Toffaletti J (1995) Physiology and regulation: ionized calcium, magnesium and lactate measurements in critical care settings. Am J Clin Pathol 104 [Suppl 1]:S88–S94

    PubMed  CAS  Google Scholar 

  5. Reinhart RA, Desbiens NA (1985) Hypomagnesemia in patients entering the ICU. Crit Care Med 13:506–507

    Article  PubMed  CAS  Google Scholar 

  6. Ryzen E, Wagers PW, Singer FR, Rude RK (1985) Magnesium deficiency in a medical ICU population. Crit Care Med 13:19–21

    Article  PubMed  CAS  Google Scholar 

  7. Chernow B, Bamberger S, Stoiko M, Vadnais M, Mills S, Hoellrich V, Warshaw AL (1989) Hypomagnesemia in patients in postoperative intensive care. Chest 95:391–397

    Article  PubMed  CAS  Google Scholar 

  8. Rubeiz GJ, Thill-Baharozian M, Hardie D, Carlson RW (1993) Association of hypomagnesemia and mortality in acutely ill medical patients. Crit Care Med 21:203–209

    Article  PubMed  CAS  Google Scholar 

  9. Drop LJ (1985) Ionized calcium, the heart, and hemodynamic function. Anesth Analg 64:432–451

    Article  PubMed  CAS  Google Scholar 

  10. Kost GJ (1993) The significance of ionized calcium in cardiac critical care. Arch Pathol Lab Med 117:890–896

    PubMed  CAS  Google Scholar 

  11. Desai TK, Carlson RW, Thill-Baharozian M, Geheb MA (1988) A direct relationship between ionized calcium and arterial pressure among patients in an intensive care unit. Crit Care Med 16:578–582

    Article  PubMed  CAS  Google Scholar 

  12. Broner CW, Stidham GL, Westenkirchner DF, Tolley EA (1990) Hypermagnesemia and hypocalcemia as predictors of high mortality in critically ill pediatric patients. Crit Care Med 18:921–928

    PubMed  CAS  Google Scholar 

  13. Wacker WEC, Parisi AF (1968) Magnesium metabolism. N Engl J Med 278:658–663

    PubMed  CAS  Google Scholar 

  14. Elin RJ (1987) Assessment of magnesium status. Clin Chem 33:1965–1970

    PubMed  CAS  Google Scholar 

  15. Günther T (1993) Mechanisms of regulation of Mg efflux and Mg influx. Miner Electrolyte Metab 19:259–265

    PubMed  Google Scholar 

  16. Speich M, Bousquet B, Nicolas G (1981) Reference values for ionized, complexed and protein-bound plasma magnesium in men and women. Clin Chem 27:246–248

    PubMed  CAS  Google Scholar 

  17. Altura BT, Altura BM (1994) A method for distinguishing ionized, complexed and protein-bound Mg in normal and diseased subjects. Scand J Clin Lab Invest 54, Suppl 217:83–87

    Article  CAS  Google Scholar 

  18. Seelig MS (1981) Magnesium requirements in human nutrition. Magnesium Bull 3 [Suppl 1A]:26–47

    Google Scholar 

  19. Graham LA, Caessar JJ, Burgen ASV (1960) Gastrointestinal absorption of Mg28 in man. Metabolism 9:646–659

    CAS  Google Scholar 

  20. Kayne LH, Lee DBN (1993) Intestinal magnesium absorption. Miner Electrolyte Metab 19:210–217

    PubMed  CAS  Google Scholar 

  21. Fine KD, Santa Ana CA, Porter JL, Fordtran JS (1991) Intestinal absorption of magnesium from food and supplements. J Clin Invest 88:396–402

    Article  PubMed  CAS  Google Scholar 

  22. Hodgkinson A, Marshall DH, Nordin BEC (1979) Vitamin D and magnesium absorption in man. Clin Sci (Colch) 57:121–123

    CAS  Google Scholar 

  23. Sutton RAL, Domrongkitchaiborn S (1993) Abnormal renal magnesium handling. Miner Electrolyte Metab 19:232–240

    PubMed  CAS  Google Scholar 

  24. Quamme GA, Dirks JH (1986) The physiology of renal magnesium handling. Renal Physiol 9:257–269

    PubMed  CAS  Google Scholar 

  25. Quamme GA (1989) Control of magnesium transport in the thick ascending limb. Am J Physiol 256:F197–F210

    PubMed  CAS  Google Scholar 

  26. Wong NLM, Dirks JH, Quamme GA (1983) Tubular reabsorptive capacity for magnesium in the dog kidney. Am J Physiol 244:F78–F83

    PubMed  CAS  Google Scholar 

  27. Coburn JW, Popovtzer MM, Massry SG, Kleeman CR (1969) The physico-chemical state and renal handling of divalent ions in chronic renal failure. Arch Intern Med 124:302–311

    Article  PubMed  CAS  Google Scholar 

  28. Quamme GA (1993) Laboratory evaluation of magnesium status. Renal function and free intercellular magnesium concentration. Clin Lab Med 13:209–223

    PubMed  CAS  Google Scholar 

  29. Dunn MJ, Walser MR (1964) Magnesium depletion in normal man. Metabolism 15:884–895

    Article  Google Scholar 

  30. Fitzgerald MG, Fourman P (1956) An experimental study of magnesium deficiency in man. Clin Sci (Colch) 15:635

    CAS  Google Scholar 

  31. Rude RK, Bethune JR, Singer FR (1980) Renal tubular maximum for magnesium in normal, hypoparathyroid and hyperparathyroid man. J Clin Endocrinol Metab 51:1425

    PubMed  CAS  Google Scholar 

  32. Alfrey AC, Miller NL, Trow R (1974) Effect of age and magnesium depletion on bone magnesium pools in rats. J Clin Invest 54:1074–1081

    Article  PubMed  CAS  Google Scholar 

  33. Alfrey AC, Miller NL (1973) Bone magnesium pools in uremia. J Clin Invest 52:3019–3027

    Article  PubMed  CAS  Google Scholar 

  34. Günther T (1990) Functional compartmentation of intracellular magnesium. In: Sigel H, Sigel A (eds) Metal ions in biological systems, vol 26. Dekker, New York, pp 193–213

    Google Scholar 

  35. Quamme GA (1997) Renal magnesium handling: new insights in understanding old problems. Kidney Int 52:1180–1195

    Article  PubMed  CAS  Google Scholar 

  36. Beyenbach KW (1990) Transport of magnesium across biological membranes. Magnes Trace Elem 9:223–254

    Google Scholar 

  37. Aikawa JK (1981) Magnesium: its biological significance. CRC, Boca Raton

    Google Scholar 

  38. Reinhart RA (1988) Magnesium metabolism: a review with special reference to the relationship between intra-cellular content and serum levels. Arch Intern Med 148:2415–2420

    Article  PubMed  CAS  Google Scholar 

  39. Garfinkel L, Garfinkel D (1985) Magnesium regulation of the glycolytic pathway and the enzymes involved. Magnesium 4:60–72

    PubMed  CAS  Google Scholar 

  40. Al-Gamadi SMG, Cameron EC, Sutton RAL (1994) Magnesium deficiency: pathophysiologic and clinical overview. Am J Kidney Dis 24:737–752

    Google Scholar 

  41. Vernon WB (1988) The role of magnesium in nucleic acid and protein metabolism. Magnesium 7:234–248

    PubMed  CAS  Google Scholar 

  42. Schumacher MA, Goodman RH, Brennan RG (2001) The structure of a CREB bZIP.somatostatin CRE complex reveals the basis for selective dimerization and divalent cation-enhanced DNA binding. J Biol Chem 10:35242–35247

    Google Scholar 

  43. Ryan MF (1991) The role of magnesium in clinical biochemistry: an overview. Ann Clin Biochem 28:19–26

    PubMed  Google Scholar 

  44. Volpe P, Vezu L (1993) Intracellular magnesium and inositol 1:4,5 triphosphate receptor: molecular mechanisms of interaction, physiology and pharmacology. Magnes Res 6:267–274

    PubMed  CAS  Google Scholar 

  45. Rude RK, Oldham SB, Sharpe CF, Singer FR (1978) Parathyroid hormone secretion in magnesium deficiency. J Clin Endocrinol Metab 47:800–806

    PubMed  CAS  Google Scholar 

  46. Rude RK, Singer FR (1981) Magnesium deficiency and excess. Annu Rev Med 32:245–259

    Article  PubMed  CAS  Google Scholar 

  47. Targovnik JH, Rodman JS, Sherwood LM (1971) Regulation of parathyroid hormone secretion in vitro: quantitative aspects of calcium and magnesium ion control. Endocrinology 88:1477–1482

    Article  PubMed  CAS  Google Scholar 

  48. Nadler JL, Rude RK (1995) Disorders of magnesium metabolism. Endocrinol Metab Clin North Am 24:623–641

    PubMed  CAS  Google Scholar 

  49. Dyckner T, Wester PO (1984) Intra-/extracellular shifts of potassium after administration of Mg in patients with cardiovascular diseases. Magnesium 3:339–345

    PubMed  CAS  Google Scholar 

  50. White RE, Hartzell HC (1989) Magnesium ions in cardiac function. Regulator of ion channels and second messengers. Biochem Pharmacol 38:859–867

    Article  PubMed  CAS  Google Scholar 

  51. Vandenberg CA (1987) Inward rectification of a potassium channel in cardiac ventricular cells depends on internal magnesium ions. Proc Natl Acad Sci USA 84:2560–2564

    Article  PubMed  CAS  Google Scholar 

  52. Whang R, Whang DD, Ryan MR (1992) Refractory potassium repletion. Arch Intern Med 152:40–45

    Article  PubMed  CAS  Google Scholar 

  53. Borzeix MG, Akimjak JP, Charles P, Lenfant M, Cahn R (1994) Effect of magnesium on GABA inhibition-induced convulsions in mice. Effect of three salts. In: Golf S, Dralle D, Vecchiet L (eds) Magnesium 1993. Libbey, London, pp 177–180

    Google Scholar 

  54. Mason BA, Standley CA, Irtenkauf SM, Bardicef M, Cotton DB (1994) Magnesium is more efficacious than phenytoin in reducing N-methyl-D-aspartate seizures in rats. Am J Obstet Gynecol 171:999–1002

    PubMed  CAS  Google Scholar 

  55. Caddell JL, Erickson M, Byrne PA (1974) Interference from citrate using the titan yellow method and two fluorometric methods for magnesium determination in plasma. Clin Chim Acta 41:435–438

    Google Scholar 

  56. Elin RJ (1991) Determination of serum magnesium concentration by clinical laboratories. Magnes Trace Elem 10:60–66

    PubMed  CAS  Google Scholar 

  57. Alfrey AC, Miller NL, Butkus D (1974) Evaluation of body magnesium stores. J Lab Clin Med 84:153–162

    PubMed  CAS  Google Scholar 

  58. Altura BT, Altura BM (1992) Measurement of ionized magnesium in whole blood, plasma and serum with a new ion-selective electrode in healthy and diseased human subjects. Magnes Trace Elem 10:90–98

    CAS  Google Scholar 

  59. Elin RJ (1988) Status of the determination of magnesium in mononuclear blood cells in humans. Magnesium 7:300–305

    PubMed  CAS  Google Scholar 

  60. Fiaccadori E, Del Canale S, Coffrini E, Melej R, Vitali P, Guariglia A, Borghetti A (1988) Muscle and serum magnesium in pulmonary intensive care unit patients. Crit Care Med 16:751–760

    Article  PubMed  CAS  Google Scholar 

  61. Luce GG (1970) Biological rhythms in psychiatry and medicine. Publication no 2088. Public Health Service, Washington

    Google Scholar 

  62. Ryzen E, Elbaum N, Singer FR, Rude RK (1985) Parenteral magnesium tolerance testing in the evaluation of magnesium deficiency. Magnesium 4:137–147

    PubMed  CAS  Google Scholar 

  63. Hébert P, Mehta N, Wang J, Hindmarsh T, Jones G, Cardinal P (1997) Functional magnesium deficiency in critically ill patients identified using a magnesium-loading test. Crit Care Med 25:749–755

    Article  PubMed  Google Scholar 

  64. Raju B, Murphy E, Levy LA, Hall RD, London RE (1989) A fluorescent indicator for measuring cytosolic free magnesium. Am J Physiol 256:C540–C548

    PubMed  CAS  Google Scholar 

  65. Illner H, McGuigan JAS, Lüthi D (1992) Evaluation of Mag-fura-5, the new fluorescent indicator for free magnesium measurements. Pflugers Arch 422:179–184

    Article  PubMed  CAS  Google Scholar 

  66. London RE (1991) Methods for measurement of intracellular magnesium: NMR and fluorescence. Annu Rev Physiol 53:241–258

    PubMed  CAS  Google Scholar 

  67. Altura BT, Shirey TL, Young CC, Hiti J, Orfano KD, Handwerker M, Altura BM (1992) A new method for the rapid determination of ionized Mg in whole blood, serum and plasma. Methods Find Exp Clin Pharmacol 14:297–304

    PubMed  CAS  Google Scholar 

  68. Huijgen HJ, Sanders R, Cecco SA, Rehak NN, Sanders GT, Elin RJ (1999) Serum ionized magnesium: comparison of results obtained with three ion-selective analyzers. Clin Chem Lab Med 37:465–470

    Article  PubMed  CAS  Google Scholar 

  69. Anonymous (1997) NOVA 8 reference manual. Nova Biomedical, Waltham

    Google Scholar 

  70. Fogh-Andersen N, Bjerrum PJ, Siggaard-Andersen O (1993) Ionic binding, net charge, and Donnan effect of human serum albumin as a function of pH. Clin Chem 39:48–52

    PubMed  CAS  Google Scholar 

  71. Welt LG, Gitelman H (1965) Disorders of magnesium metabolism. DM 11:1–32

    Google Scholar 

  72. Kingston ME, Al-Siba'i MB, Skooge WC (1986) Clinical manifestations of hypomagnesemia. Crit Care Med 14:950–954

    Article  PubMed  CAS  Google Scholar 

  73. Sutton RL, Dirks JH (1991) Disturbances of calcium and magnesium metabolism. In: Brenner BM, Rector FR (ed) The kidney, vol 1, 4th edn. Saunders, Philadelphia, pp 841–887

    Google Scholar 

  74. Shills ME (1969) Experimental human magnesium depletion. Medicine (Baltimore) 48:61–85

    Article  Google Scholar 

  75. Wacker WEC, Moore FD, Ulmer DD, Vallee BL (1962) Normocalcemic magnesium deficiency tetany. JAMA 180:161–163

    CAS  Google Scholar 

  76. Ryzen E, Wagers PW, Singer FR, Rude RK (1985) Magnesium deficiency in a medical ICU population. Crit Care Med 13:19–21

    Article  PubMed  CAS  Google Scholar 

  77. Abdulrazzaq YM, Smigura FC, Wettrell G (1989) Primary infantile hypomagnesemia; report of two cases and review of literature. Eur J Pediatr 148:459–461

    Article  PubMed  CAS  Google Scholar 

  78. Iseri LT, Allen BJ, Brodsky MA (1989) Magnesium therapy of cardiac arrhythmias in critical care medicine. Magnesium 8:299–306

    PubMed  CAS  Google Scholar 

  79. Whang R, Oei TO, Aikawa JK, Vannatta J, Fryer A, Markanich M (1984) Predictors of clinical hypomagnesemia. Arch Intern Med 144:1794–1796

    Article  PubMed  CAS  Google Scholar 

  80. Keller P, Aronson R (1990) The role of magnesium in cardiac arrhythmias. Prog Cardiovasc Dis 32:433–448

    Article  PubMed  CAS  Google Scholar 

  81. Watanabe Y, Dreifus LS (1972) Electrophysiological effects of magnesium and its interaction with potassium. Cardiovasc Res 6:79–88

    Article  PubMed  CAS  Google Scholar 

  82. Iseri LT, Freed J, Bures AR (1975) Magnesium deficiency and cardiac disorders. Am J Med 58:837–844

    Article  PubMed  CAS  Google Scholar 

  83. Burch GE, Giles TD (1977) The importance of magnesium deficiency in cardiovascular disease. Am Heart J 94:649–657

    Article  PubMed  CAS  Google Scholar 

  84. Fawcett WJ, Haxby EJ, Male DA (1999) Magnesium: physiology and pharmacology. Br J Anaesth 83:302–320

    PubMed  CAS  Google Scholar 

  85. Tzivoni D, Banai S, Schuger C, Benhorin J, Keren A, Gottlieb S, Stern S (1988) Treatment of torsade de pointes with magnesium sulfate. Circulation 77:392–397

    PubMed  CAS  Google Scholar 

  86. Ralston MA, Murnane MR, Kelley RE, Altschuld R, Unverferth DV, Leier CV (1989) Magnesium content of serum, circulating mononuclear cells, skeletal muscle, and myocardium in congestive heart failure. Circulation 80:573–580

    PubMed  CAS  Google Scholar 

  87. Hall RCW, Joffre JR (1973) Hypomagnesemia: physical and psychiatric symptoms. JAMA 224:1749–1751

    Article  PubMed  CAS  Google Scholar 

  88. Booth CC, Babouris N, Hanna S, MacIntyre I (1963) Incidence of hypomagnesemia in intestinal malabsorption. BMJ 2:141–144

    Article  PubMed  CAS  Google Scholar 

  89. Edmondson HA, Berne CJ, Homann RE, Wertman M (1952) Calcium, potassium, magnesium and amylase disturbances in acute pancreatitis. Am J Med 12:34–42

    Article  PubMed  CAS  Google Scholar 

  90. Davis BB, Preuss HG, Murdaugh HV Jr (1975) Hypomagnesemia following the diuresis of post-renal obstruction and renal transplant. Nephron 14:275–280

    Article  PubMed  CAS  Google Scholar 

  91. Schilsky RL, Anderson T (1979) Hypomagnesemia and renal magnesium wasting in patients receiving cisplatin. Ann Intern Med 90:929–931

    PubMed  CAS  Google Scholar 

  92. Shah GM, Kirschenbaum MA (1991) Renal magnesium wasting associated with therapeutic agents. Miner Electrolyte Metab 17:58–64

    PubMed  CAS  Google Scholar 

  93. Von Vigier RO, Truttmann AC, Zindler-Schmocker K, Bettinelli A, Aebischer CC, Wermuth B, Bianchetti MG (2000) Aminoglycosides and renal magnesium homeostasis in humans. Nephrol Dial Transplant 15:822–826

    Article  PubMed  CAS  Google Scholar 

  94. Barton CH, Pahl M, Vaziri ND, Cesario T (1984) Renal magnesium wasting associated with amphotericin B therapy. Am J Med 77:471–474

    Article  PubMed  CAS  Google Scholar 

  95. Barton CH, Vaziri ND, Martin DC, Choi S, Alikhani S (1987) Hypomagnesemia and renal magnesium wasting in renal transplant recipients receiving cyclosporine. Am J Med 83:693–699

    Article  PubMed  CAS  Google Scholar 

  96. Shah GM, Alvarado P, Kirschenbaum MA (1990) Symptomatic hypocalcemia and hypomagnesemia with renal magnesium wasting associated with pentamidine therapy in a patients with AIDS. Am J Med 89:380–382

    Article  PubMed  CAS  Google Scholar 

  97. Knochel JP (1977) The pathophysiology and clinical characteristics of severe hypophosphatemia. Arch Intern Med 137:203–220

    Article  PubMed  CAS  Google Scholar 

  98. Martin HE, Smith K, Wilson ML (1958) The fluid and electrolyte therapy of severe diabetic acidosis and ketosis. Am J Med 24:376–389

    Article  PubMed  CAS  Google Scholar 

  99. Delva P, Pastori C, Degan M, Montesi G, Brazzarola P, Lechi A (2000) Intralymphocyte free magnesium with primary aldosteronism. Hypertension 35:113–117

    PubMed  CAS  Google Scholar 

  100. Lim P, Jacob E (1972) Magnesium deficiency in liver cirrhosis. Q J Med 41:291–300

    PubMed  CAS  Google Scholar 

  101. Hellman ES, Tschudy DP, Bartter FC (1962) Abnormal electrolyte and water metabolism in acute intermittent porphyria. The transient inappropriate secretion of antidiuretic hormone. Am J Med 32:734–746

    Article  PubMed  CAS  Google Scholar 

  102. Jones JE, Desper PC, Shane SR, Flink EB (1966) Magnesium metabolism in hyperthyroidism and hypothyroidism. J Clin Invest 45:891–900

    Article  PubMed  CAS  Google Scholar 

  103. Davies DR, Friedman M (1966) Complications after parathyroidectomy. Fractures from low calcium and magnesium convulsions. J Bone Joint Surg Br]48:117–126

    PubMed  CAS  Google Scholar 

  104. Navarro J, Oster JR, Gkonos PJ, Ruiz JP, Rhamy RK, Perez GO (1991) Tetany induced on separate occasions by administration of potassium and magnesium in a patient with hungry-bone syndrome. Miner Electrolyte Metab 17:340–344

    PubMed  CAS  Google Scholar 

  105. Whyte KF, Addis GJ, Whitesmith R, Reid JL (1987) Adrenergic control of plasma magnesium in man. Clin Sci (Colch) 72:135–138

    CAS  Google Scholar 

  106. McLellan BA, Reid SR, Lane PL (1984) Massive blood transfusion causing hypomagnesemia. Crit Care Med 12:146–147

    PubMed  CAS  Google Scholar 

  107. England MR, Gordon G, Salem M, Chernow B (1992) Magnesium administration and dysrhythmia after cardiac surgery. JAMA 268:2395–2402

    Article  Google Scholar 

  108. Aziz S, Haigh WG, Van Norman GA, Kenny RJ, Kenny MA (1996) Blood ionized magnesium concentrations during cardiopulmonary bypass and their correlation with other circulating cations. J Card Surg 11:341–347

    Article  PubMed  CAS  Google Scholar 

  109. Shane SR, Flink EB (1992) Magnesium deficiency in alcohol addiction and withdrawal. Magnes Trace Elem 10:263–268

    CAS  Google Scholar 

  110. Weglicki WB, Phillips TM (1992) Pathobiology of magnesium deficiency: a cytokine/neurogenic inflammation hypothesis. Am J Physiol 32:R734–737

    Google Scholar 

  111. Weglicki WB, Freedman AM, Bloom S, Atrakchi AH, Cassidy MM, Dickens BF (1992) Antioxidants and the cardiomyopathy of Mg-deficiency. Am J Cardiovasc Pathol 4:210–215

    PubMed  CAS  Google Scholar 

  112. Weglicki WB, Phillips TM, Freedman AM, Cassidy MM, Dickens BF (1992) Magnesium-deficiency elevates circulating levels of inflammatory cytokines and endothelin. Mol Cell Biochem 110:169–173

    Article  PubMed  CAS  Google Scholar 

  113. Altura BM, Altura BT (1990) Role of magnesium in the pathogenesis of hypertension: relationship to its actions on cardiac and vascular smooth muscle. In: Laragh JH, Brenner BM (ed) Hypertension: pathophysiology, diagnosis and management. Raven, New York, pp 1003–1025

    Google Scholar 

  114. White RE, Hartzell HC (1988) Effects of intracellular free magnesium on calcium current in isolated cardiac myocytes. Science 239:778–780

    Article  PubMed  CAS  Google Scholar 

  115. Murphy E, Steenbergen C, Levy LS, Raju B, London RE (1989) Cytosolic free magnesium levels in ischemic rat heart. J Biol Chem 264:5622–5627

    PubMed  CAS  Google Scholar 

  116. Sayeed MM, Zhu M, Maitra SR (1989) Alterations in cellular calcium and magnesium during circulatory/septic shock. Magnesium 8:179–189

    PubMed  CAS  Google Scholar 

  117. Günther T, Ebel H (1990) Membrane transport of magnesium. Metal Ions Biol Syst 26:216–225

    Google Scholar 

  118. Salem M, Kasinski N, Munoz R, Chernow B (1995) Progressive magnesium deficiency increases mortality from endotoxin challenge: protective effects of acute magnesium replacement. Crit Care Med 23:108–118

    Article  PubMed  CAS  Google Scholar 

  119. Johnson JS, Hand WL, King-Thompson NL (1980) The role of divalent cations in interactions between lymphokines and macrophages. Cell Immunol 53:236–245

    Article  PubMed  CAS  Google Scholar 

  120. Weglicki WB, Mak IT, Stafford RE, Dickens BF, Cassidy MM, Philliips TM (1994) Neurogenic peptides and the cardiomyopathy of Mg-deficiency: effects of substance P receptor inhibition. Mol Cell Biochem 130:103–109

    Article  PubMed  CAS  Google Scholar 

  121. Mak IT, Komarov AM, Wagner TL, Stafford RE, Dickens BF, Weglicki WB (1996) Enhanced NO production during Mg deficiency and its role in mediating red blood cell glutathione loss. Am J Physiol 271:C385–C390

    PubMed  CAS  Google Scholar 

  122. Schmidt HH, Walter U (1994) NO at work. Cell 78:919–925

    Article  PubMed  CAS  Google Scholar 

  123. Külpmann WR, Gerlach M (1996) Relationship between ionized and total magnesium in serum. Scand J Clin Lab Invest 56 [Suppl 224]:251–258

    Article  Google Scholar 

  124. Altura BM, Altura BT (1996) Role of magnesium in patho-physiological processes and the clinical utility of magnesium ion selective electrodes. Scand J Clin Lab Invest 56 [Suppl 224]:211–234

    Article  CAS  Google Scholar 

  125. Zhang A, Cheng TPO, Altura BT, Altura BM (1992) Extracellular magnesium regulates intracellular free Mg in vascular smooth muscle cells. Pflugers Arch 421:391–393

    Article  PubMed  CAS  Google Scholar 

  126. Salem M, Stacey J, Chernow B (1993) Ionized magnesium values in critically ill patients – a novel ion selective electrode for determining free extracellular magnesium concentrations. Crit Care Med:S256

    Google Scholar 

  127. Huijgen HJ, Soesan M, Sanders R, Mairuhu WM, Kesecioglu J, Sander GT (2000) Magnesium levels in critically ill patients: what should we measure? Am J Clin Pathol 114:688–695

    Article  PubMed  CAS  Google Scholar 

  128. Kasaoka S, Tsuruta R, Nakashima K, Soejima Y, Miura T, Sadamitsu D, Tateishi A, Maekawa T (1996) Effect of intravenous magnesium sulfate on cardiac arrhythmias in critically ill patients with low serum ionized magnesium. Jpn Circ J 60:871–875

    Article  PubMed  CAS  Google Scholar 

  129. Bertschat F, Ising H, Günther T, Jeremias A, Jeremias E (1995) Changes of ionized magnesium and free fatty acids in serum after myocardial infarction. Eur J Clin Chem Clin Biochem 33:553–558

    PubMed  CAS  Google Scholar 

  130. Frankel H, Haskell R, Lee SY, Miller D, Rotondo M, Schwab CW (1999) Hypomagnesemia in trauma patients. World J Surg 23:966–969

    Article  PubMed  CAS  Google Scholar 

  131. Sawyer RB, Drew MA, Gesink MH, Sawyer KC Jr, Sawyer DC (1970) Post-operative magnesium metabolism. Arch Surg 100:343–348

    PubMed  CAS  Google Scholar 

  132. Heath DL, Vink R (1998) Blood-free magnesium concentration declines following graded experimental traumatic brain injury. Scand J Clin Invest 58:161–166

    Article  PubMed  CAS  Google Scholar 

  133. Altura BM, Memon ZS, Altura BT, Cracco RQ (1995) Alcohol-associated acute head trauma in human subjects is associated with early deficits in serum ionized Mg and Ca. Alcohol 12:433–437

    Article  PubMed  CAS  Google Scholar 

  134. Heath DL, Vink R (1998) Neuroprotective effects of MgSO4 and MgCl2 in closed head injury: a comparative phosphorous NMR study. J Neurotrauma 15:183–189

    Article  PubMed  CAS  Google Scholar 

  135. Smith DH, Okiyama K, Gennarelli TA, McIntosh TK (1993) Magnesium and ketamine attenuate cognitive dysfunction following experimental brain injury. Neurosci Lett 157:211–214

    Article  PubMed  CAS  Google Scholar 

  136. Kinoshita Y, Ueyuama T, Senba E, Terada T, Nakai K, Itakura T (2001) Expression of c-fos, heat shock protein 70, neurotrophins, and cyclooxygenase-2 mRNA in response to focal cerebral ischemia/reperfusion in rats and their modification by magnesium sulfate. J Neurotrauma 18:435–445

    Article  PubMed  CAS  Google Scholar 

  137. Bareyre FM, Saatman KE, Helfaer MA, Sinson G, Weisser JD, Brown AL, McIntosh TK (1999) Alterations in ionized and total blood magnesium after experimental traumatic brain injury: relationship to neurobehavioral outcome and neuroprotective efficacy of magnesium chloride. J Neurochem 73:271–280

    Article  PubMed  CAS  Google Scholar 

  138. Feldman Z, Gurevitch B, Artru A, Oppenheim A, Shohami E, Reichenthal E, Shapira Y (1996) Effect of magnesium given 1 hour after head trauma on brain edema and neurological outcome. J Neurosurg 85:131–137

    Article  PubMed  CAS  Google Scholar 

  139. Regan RF, Jasper E, Guo Y, Panter SS (1998) The effect of magnesium on oxidative neuronal injury in vitro. J Neurochem 70:77–85

    Article  PubMed  CAS  Google Scholar 

  140. James MFM (1991) Magnesium in critical care medicine. Care Crit Ill 7:233–237

    Google Scholar 

  141. Iseri LT, Freed J, Bures AR (1975) Magnesium deficiency and cardiac disorders. Am J Med 58:837–846

    Article  PubMed  CAS  Google Scholar 

  142. Rasmussen HS, Thomsen PEB (1989) The electrophysiological effects of intravenous magnesium sulfate on human sinus node, atrioventricular node, atrium, and ventricle. Clin Cardiol 12:85–90

    Article  PubMed  CAS  Google Scholar 

  143. Davies GE, Cudworth P, Lawler PG (1992) Intravenous magnesium in critically ill patients. Anaesthesia 47:1104

    Article  PubMed  CAS  Google Scholar 

  144. Barrera R, Fleischer M, Miletic J, Groeger J (2000) Ionized magnesium supplementation in critically ill patients: comparing ionized and total magnesium. J Crit Care 15:36–40

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Pulmonary, critical care and occupational Medicine Departments of internal Medicine and Pharmacological and Physiological science school of Medicine, Saint Louis University, 3635 Vista Ave, 63110-0250, Saint Louis, MO, USA

    J. Luis Noronha

  2. Division of Pulmonary, critical care and occupational Medicine Departments of internal Medicine and Pharmacological and Physiological science school of Medicine, Saint Louis University, 3635 Vista Ave, 63110-0250, Saint Louis, MO, USA

    George M. Matuschak

Authors
  1. J. Luis Noronha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. George M. Matuschak
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

    Rights and permissions

    Reprints and permissions

    Copyright information

    © 2009 Springer-Verlag Berlin Heidelberg

    About this chapter

    Cite this chapter

    Noronha, J.L., Matuschak, G.M. (2009). Magnesium in critical illness: metabolism, assessment, and treatment. In: Hedenstierna, G., Mancebo, J., Brochard, L., Pinsky, M. (eds) Applied Physiology in Intensive Care Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-01769-8_36

    Download citation

    • DOI: https://doi.org/10.1007/978-3-642-01769-8_36

    • Published:

    • Publisher Name: Springer, Berlin, Heidelberg

    • Print ISBN: 978-3-642-01768-1

    • Online ISBN: 978-3-642-01769-8

    • eBook Packages: MedicineMedicine (R0)

    Publish with us

    Policies and ethics

    Search

    Navigation