Mike,
Don't have a definite answer to your question, but related to it is the
recommended use of prophylactic IV magnesium as an anticonvulsant in
pre-eclampsia (outcome of MAGPIE trial).
I have seen published guidelines recommending a target therapeutic range for
serum magnesium of 2 - 4 mmol/L, with toxicity at >6 mmol/L.
However, I don't recall ever being asked to do magnesiums in this situation
(yet), and I believe that the obstetricians check for Mg toxicity purely by
monitoring the patellar reflex for hyporeflexia.
Best wishes,
Stuart
Stuart Robertson
Clinical Biochemistry Dept
Hull Royal Infirmary
HU3 2JZ
----------
From: [log in to unmask] [SMTP:[log in to unmask]]
Sent: 23 July 2002 11:05
To: [log in to unmask]
Subject: Magnesium infusions
Like many of you I suspect we have observed an exponential rise in
requests or plasma magnesium from our ICU in the last few years.
This started with patients with meningococcal meningitis but now
almost all patients have magnesium results several times a day. I
confess to not having done an extensive literature search but I am
pretty sure that the evidence base for the clinical usefulness of
these
measurements is pretty thin. It must be incredibly difficult to
sort out
the effects of a low plasma magnesium from all the other problems in
patients on ICU.
However, now a new phenomenon has arisen which is the treatment of
patients plasma magnesium concentrations in the low normal range
with magnesium infusions leading in at least one case to a
concentration well above the upper reference limit. On talking to
one
of my adult colleagues I find we are not alone and this is happening
elsewhere. Can anyone shed any light on this? Are there real
dangers
in this apparently cavalier approach to treating biochemistry and
not
the patient?
Mike Addison
.
Dr G.Michael Addison
Royal Manchester Children's Hospital
Pendlebury
Manchester M27 4HA
United Kingdom
Tel 0161-727-2250(AM)or 0161-220-5342(PM)
FAX 0161-727-2249
Email [log in to unmask]
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