Magnesium for Sedation in Mechanically Ventilated Patients?

This is cool, really cool. We need more data, but this is a great start. I learned a lot of basic science from reading the introduction as well as discussion on this article and it all makes sense. I don't see myself using this anytime soon until there's a study where they add magnesium to a different agent that's not midazolam because I do not use benzodiazepines in my practice for sedation unless there are extreme cases.

I encourage you read this article yourself as it's interesting and I don't want to divulge too much out of respect for the authors.

-EJ



Link to Abstract

Link to FREE FULL PDF

Altun, Dilek. (2019). Can we use Magnesium for sedation in Intensive Care Unit for critically ill patients; Is it as effective as other sedatives?. Ağrı - The Journal of The Turkish Society of Algology. 31.

Although great care has been taken to ensure that the information in this post is accurate, eddyjoemd, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.

Mechanism of Hypokalemia in Magnesium Deficiency

In the ICU, we are at times obsessed with making our patients “euboxic” or better said, all labs values within normal ranges. That being said, electrolytes are something we replete every day and our nurses often have protocols which instruct them on how to manage and correct these derangement to hopefully optimize the outcomes of our patients. When I was a resident, one of my mentors and a good friend to this day taught me to correct the Magnesium before correcting the potassium. This left me scratching my head. It made no sense. And the he went on to explain the mechanisms listed in this article and my mind was blown. How much other stuff do I not know? How come I wasn’t taught this in med school? Well friends, there A LOT that we weren’t taught in med school or even residency and fellowship training for that matter. That pretty much why I’m on this lifelong learning journey and hopefully bringing you all along for the ride. This article is free and it’s a good review for you all to check out. To the cool nurses on Instagram, mid sharing this with your colleagues? This is also must know medicine for any internal medicine intern and resident working the wards and ICU. Tony Breu totally killed this subject in a much more thorough and intelligent manner than I did several months ago on twitter. Follow him @tony_breu.
-EJ

Link to Abstract

Link to PDF

Huang, C.-L., & Kuo, E. (2007). Mechanism of Hypokalemia in Magnesium Deficiency. Journal of the American Society of Nephrology, 18(10), 2649–2652.

Although great care has been taken to ensure that the information in this post is accurate, eddyjoemd, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.