Role of Prophylactic Magnesium Supplementation in ICU Patients in Avoiding Other Dyselectrolytemias and their Complications

AIM AND OBJECTIVES: To study the role of prophylactic magnesium supplementation in avoiding other dyselectrolytemias and their complications. Primary Objective: To study if there is a possibility to avoid other electrolyte disturbances like hypokalemia, hypocalcemia, hypophosphatemia by supplementing enteral magnesium to the patients. MATERIALS AND METHODS: A Prospective observational study was carried out in 30 patients admitted in ICU based on the following inclusion and exclusion criteria. INCLUSION CRITERIA: Age: 18 to 65 years. Either gender. ICU stay of atleast 5 days. EXCLUSION CRITERIA: Patients with Renal dysfunction. Patients with history of cardiac arrhythmias or rhythm abnormalities at the time of admission. Patients with already existing electrolyte disturbance for which corrections were started. METHODOLOGY: All the patients satisfying the inclusion and exclusion criteria were supplemented with Enteral magnesium (oral/ryles tube) of 400 mg twice daily on the first 2 days and once daily on the next 3 days. Serum potassium, phosphorous, calcium levels were measured daily for the next 4 days. Serum magnesium was measured on the day 5 of ICU stay to rule out any iatrogenic hypermagnesemia. RESULTS: 21 patients had normal electrolytes during the next 4 days of hospital stay. 7 patients had mild hypokalemia on day 2 for which oral supplementation was added. 2 patients required parenteral potassium and phosphorous supplementation one day followed by enteral supplementation for 2 days. Significant hypocalcemia was not observed in any of the cases. No ECG rhythm abnormalities were found in any of the patients. Neither of the patients had hypermagnesemia on day-5. CONCLUSION: Prophylactic supplementation of magnesium can help in reducing the incidence of other dyselectrolytemias in ICU patients thus reducing the requirement of those electrolyte supplementation which require close monitoring. It can help in avoiding the complications secondary to these dyselectrolytemias. However, randomized controlled trials in a larger sample size need to be carried out where the results can be compared with the control group thus giving a statistically significant result which can help in clinical application for a better patient outcome. Our study can help in forming the basis for carrying out further studies.