Hyopomagnesemia in Critically Ill Children

2018 
Objectives: To investigate the incidence of hypomagnesemia, hypomagnesemia-associated risk factors, and the effect of hypomagnesemia effect on prognosis among patients followed at pediatric intensive care unit. Methods: This study enrolled patients who were admitted to the Pediatric Intensive Care Unit between January and December 2017. Patients' admission serum Mg level was measured, and a level below 1.8 mEq/L was considered hypomagnesemia. Patients with hypomagnesemia were grouped as group 1 and those with normal serum magnesium level as group 2. Results: A total of 59 (39.9%) of the 148 patients were female and 89 (60.1%) were male; the mean age was 62.82 ± 72.8 (min: 2 – max: 245) months. Compared with the normomagnesemic patients, those with hypomagnesemia had a greater mean age (P: 0.04), PRISM score (P: 0.015), duration of intensive care unit stay, (P: 0.001), mechanical ventilator need (P: 0.016) and the number of days connected to mechanical ventilator (P: 0.027), having nasogastric drainage (P: 0.02), and mortality rate (P: 0.041). No significant difference was found between the groups with respect to diuretic use. Increase risk of hypomagnesemia by nasogastric drainage was not significant (P: 0.082). The rates of hypokalemia, hypocalcemia, hypophosphatemia, and hypoalbuminemia were significantly greater in group 1 (P < 0.05). Hypokalemia increased the risk of hypomagnesemia by 5.13 times, hypophosphatemia by 21.8 times, hypoalbuminemia by 5.12 times, and nasogastric drainage by 3.01 times. Conclusions: It should be noted that hypomagnesemia might be common and associated with mortality among patients admitted to pediatric intensive care units. Therefore, serum magnesium level should be closely monitored.
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