The Association Between Admission Magnesium Concentrations and Lactic Acidosis in Critical Illness
Introduction: Although magnesium plays an important role in aerobic metabolism and magnesium deficiency is a common phenomenon in critical illness, the association between magnesium deficiency and lactic acidosis in the intensive care unit (ICU) has not been defined. Methods: This was a retrospectiv...
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| Format: | Article |
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SAGE Publications
2017
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| Online Access: | http://hdl.handle.net/1721.1/112813 https://orcid.org/0000-0001-8593-9321 https://orcid.org/0000-0002-6318-2978 |
| _version_ | 1826207025850220544 |
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| author | Moskowitz, Ari Donnino, Michael W. Danziger, John Lee, Joonwu Mark, Roger G Celi, Leo Anthony G. |
| author2 | Institute for Medical Engineering and Science |
| author_facet | Institute for Medical Engineering and Science Moskowitz, Ari Donnino, Michael W. Danziger, John Lee, Joonwu Mark, Roger G Celi, Leo Anthony G. |
| author_sort | Moskowitz, Ari |
| collection | MIT |
| description | Introduction: Although magnesium plays an important role in aerobic metabolism and magnesium deficiency is a common phenomenon in critical illness, the association between magnesium deficiency and lactic acidosis in the intensive care unit (ICU) has not been defined. Methods: This was a retrospective, cross-sectional study conducted at a 77 ICU bed tertiary medical center. Data pertaining to the first unique admission of any ICU patient between 2001 and 2008 were extracted from the Multiparameter Intelligent Monitoring in Intensive Care database. Hypomagnesemia was defined as serum magnesium < 1.6 mg/dL. Mild and severe lactic acidosis were defined as lactate concentrations of > 2 and > 4 mmol/L, respectively. Multivariate modeling was used to explore the association between magnesium and lactate concentrations. Results: Of 8922 critically ill patients, 22.6% were hypomagnesemic. Hypomagnesemia was associated with an increased adjusted risk of mild lactic acidosis (odds ratio [OR] 1.71, 95% confidence interval [95%CI] 1.51-1.94, P < .001) and severe lactic acidosis (OR 1.56, 95%CI 1.32-1.84, P < .001) than the reference quartile. The association between hypomagnesemia and mild lactic acidosis was stronger in those at risk of magnesium deficiency, including diabetics (OR 2.02, 95%CI 1.51-2.72, P < .001) and alcoholics (OR 1.92, 95%CI 1.16-3.19, P =.01). As an internal model control, hypokalemia was not associated with an increased risk of lactic acidosis. Conclusions: Magnesium deficiency is a common finding in patients admitted to the ICU and is associated with lactic acidosis. Our findings support the biologic role of magnesium in metabolism and raise the possibility that hypomagnesemia is a correctable risk factor for lactic acidosis in critical illness. |
| first_indexed | 2024-09-23T13:42:39Z |
| format | Article |
| id | mit-1721.1/112813 |
| institution | Massachusetts Institute of Technology |
| last_indexed | 2024-09-23T13:42:39Z |
| publishDate | 2017 |
| publisher | SAGE Publications |
| record_format | dspace |
| spelling | mit-1721.1/1128132022-10-01T16:41:27Z The Association Between Admission Magnesium Concentrations and Lactic Acidosis in Critical Illness Moskowitz, Ari Donnino, Michael W. Danziger, John Lee, Joonwu Mark, Roger G Celi, Leo Anthony G. Institute for Medical Engineering and Science Lee, Joonwu Mark, Roger G Celi, Leo Anthony G. Introduction: Although magnesium plays an important role in aerobic metabolism and magnesium deficiency is a common phenomenon in critical illness, the association between magnesium deficiency and lactic acidosis in the intensive care unit (ICU) has not been defined. Methods: This was a retrospective, cross-sectional study conducted at a 77 ICU bed tertiary medical center. Data pertaining to the first unique admission of any ICU patient between 2001 and 2008 were extracted from the Multiparameter Intelligent Monitoring in Intensive Care database. Hypomagnesemia was defined as serum magnesium < 1.6 mg/dL. Mild and severe lactic acidosis were defined as lactate concentrations of > 2 and > 4 mmol/L, respectively. Multivariate modeling was used to explore the association between magnesium and lactate concentrations. Results: Of 8922 critically ill patients, 22.6% were hypomagnesemic. Hypomagnesemia was associated with an increased adjusted risk of mild lactic acidosis (odds ratio [OR] 1.71, 95% confidence interval [95%CI] 1.51-1.94, P < .001) and severe lactic acidosis (OR 1.56, 95%CI 1.32-1.84, P < .001) than the reference quartile. The association between hypomagnesemia and mild lactic acidosis was stronger in those at risk of magnesium deficiency, including diabetics (OR 2.02, 95%CI 1.51-2.72, P < .001) and alcoholics (OR 1.92, 95%CI 1.16-3.19, P =.01). As an internal model control, hypokalemia was not associated with an increased risk of lactic acidosis. Conclusions: Magnesium deficiency is a common finding in patients admitted to the ICU and is associated with lactic acidosis. Our findings support the biologic role of magnesium in metabolism and raise the possibility that hypomagnesemia is a correctable risk factor for lactic acidosis in critical illness. 2017-12-19T20:42:57Z 2017-12-19T20:42:57Z 2014-04 2013-12 2017-12-19T15:40:54Z Article http://purl.org/eprint/type/JournalArticle 0885-0666 1525-1489 http://hdl.handle.net/1721.1/112813 Moskowitz, Ari et al. “The Association Between Admission Magnesium Concentrations and Lactic Acidosis in Critical Illness.” Journal of Intensive Care Medicine 31, 3 (April 2014): 187–192 © SAGE Publications https://orcid.org/0000-0001-8593-9321 https://orcid.org/0000-0002-6318-2978 http://dx.doi.org/10.1177/0885066614530659 Journal of Intensive Care Medicine Creative Commons Attribution-Noncommercial-Share Alike http://creativecommons.org/licenses/by-nc-sa/4.0/ application/pdf SAGE Publications PMC |
| spellingShingle | Moskowitz, Ari Donnino, Michael W. Danziger, John Lee, Joonwu Mark, Roger G Celi, Leo Anthony G. The Association Between Admission Magnesium Concentrations and Lactic Acidosis in Critical Illness |
| title | The Association Between Admission Magnesium Concentrations and Lactic Acidosis in Critical Illness |
| title_full | The Association Between Admission Magnesium Concentrations and Lactic Acidosis in Critical Illness |
| title_fullStr | The Association Between Admission Magnesium Concentrations and Lactic Acidosis in Critical Illness |
| title_full_unstemmed | The Association Between Admission Magnesium Concentrations and Lactic Acidosis in Critical Illness |
| title_short | The Association Between Admission Magnesium Concentrations and Lactic Acidosis in Critical Illness |
| title_sort | association between admission magnesium concentrations and lactic acidosis in critical illness |
| url | http://hdl.handle.net/1721.1/112813 https://orcid.org/0000-0001-8593-9321 https://orcid.org/0000-0002-6318-2978 |
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