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Research Article| Volume 7, ISSUE 1, P225-252, January 1991

Hypomagnesemia in Critical Illness

A Common and Clinically Important Problem
  • Michael Salem
    Correspondence
    Address reprint requests to: Bart Chernow, MD, FACP, Physician-in-Chief, Sinai Hospital of Baltimore, Belvedere at Greenspring Avenue, Baltimore, MD 21215
    Affiliations
    Research Fellow, Department of Medicine, Sinai Hospital of Baltimore, Departments of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
    Search for articles by this author
  • Ricardo Munoz
    Affiliations
    Research Fellow, Department of Pediatrics, Anesthesia (Critical Care), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
    Search for articles by this author
  • Bart Chernow
    Affiliations
    Physician-in-Chief, Sinai Hospital of Baltimore, Baltimore, Maryland
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DOI:https://doi.org/10.1016/S0749-0704(18)30334-8
Hypomagnesemia in Critical Illness
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      This paper is only available as a PDF. To read, Please Download here.
      Magnesium is an important mineral in normal bodily function. A host of abnormalities in critically ill patients is associated with derangements in magnesium metabolism. This article details some of the abnormalities in physiologic function in the setting of hypomagnesemia, and provides a strategy for magnesium repletion.
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      References

        • Abraham A.S.
        • Eylath U.
        • Weinstein M.
        • et al.
        Serum Mg levels in patients with acute myocardial infarction.
        N Engl J Med. 1973; 296: 862-863
        • Abraham A.S.
        • Rosenmann D.
        • Meshulam Z.
        • et al.
        Serum, lymphocyte, and erythrocyte potassium, magnesium, and calcium concentrations and their relation to tachyarrhythmias in patients with acute myocardial infarction.
        Am J Med. 1986; 81: 983-988
        • Abraham A.S.
        • Bar-On E.
        • Eylath U.
        Changes in the Mg content of tissues following myocardial damage in rats.
        Med Biol. 1981; 59: 99-102
        • Abraham A.S.
        • Rosenmann D.
        • Kramer M.
        • et al.
        Mg in the prevention of lethal arrhythmias in acute myocardial infarction.
        Arch Intern Med. 1987; 147: 753-755
        • Abraham A.S.
        • Rosenmann D.
        • Zion M.M.
        • et al.
        Lymphocyte potassium and Mg concentrations as prognostic factors after acute myocardial infarction.
        Cardiology. 1988; 75: 194-199
        • Aglio L.S.
        • Stanford G.G.
        • Maddi R.
        • et al.
        Hypomagnesemia is common following cardiac surgery.
        J Cardiovasc Anes. 1990; (in press)
        • Agus A.S.
        • Kelepouris E.
        • Dukes I.
        • et al.
        Cystolic Mg modulates calcium channel activity in mammalian ventricular cells.
        Am J Physiol. 1989; 256: C452-C455
        • Allgrove J.
        • Adami S.
        • Reuben F.
        • et al.
        Hypomagnesemia: Studies of parathyroid hormone secretion and function.
        Clin Endocrinol. 1984; 21: 435-449
        • Altura B.
        Mg-neurohypophyseal hormone interactions in contraction of vascular smooth muscle.
        Am J Phsyiol. 1975; 228: 1615-1620
        • Altura B.M.
        • Altura B.T.
        Mg withdrawal and contraction of arterial smooth muscle: Effects of EDTA, EGTA, and divalent cations (39300).
        Proc Soc Exp Biol Med. 1976; 151: 752-755
        • Altura B.M.
        • Altura B.T.
        Magnesium ions and concentration of vascular smooth muscles: Relationship to some vascular diseases.
        Fed Proc. 1981; 40: 2672-2679
        • Altura B.M.
        • Altura B.T.
        Influence of magnesium on vascular smooth muscle and serum biochemical parameters from diabetic and hypertensive rats.
        Magnesium. 1983; 2: 253-266
        • Altura B.M.
        • Altura B.T.
        • Carella A.
        Mg deficiency-induced spasms of umbilical vessels: Relation to preeclampsia, hypertension, growth retardation.
        Science. 1983; 221: 376-377
        • Altura B.M.
        • Altura B.T.
        Interactions of Mg and K on blood vessels—aspects in view of hypertension.
        Magnesium. 1984; 3: 175-194
        • Altura B.T.
        • Altura B.M.
        Interactions of Mg and K on cerebral vessels—aspects in view of stroke.
        Magnesium. 1984; 3: 195-211
        • Altura B.M.
        • Altura B.T.
        Mg, electrolyte transport and coronary vascular tone.
        Drugs. 1984; 28: 120-142
        • Anast O.F.
        • Winnacker J.L.
        • Frete L.R.
        • et al.
        Impaired release of parathyroid hormone in Mg deficiency.
        J Clin Endocrinol Metab. 1978; 42: 707-716
        • Bajpai P.C.
        • Sugden D.
        • Stern L.
        • et al.
        Serum ionic Mg in exchange transfusion.
        J Pediatr. 1967; 70: 193-199
        • Bar R.S.
        • Wilson H.E.
        • Mazzaferri E.L.
        Hypomagnesemic hypocalcemia secondary to renal magnesium wasting.
        Ann Intern Med. 1975; 82: 646-649
        • Beller G.A.
        • Hood W.B.
        • Smith T.W.
        • et al.
        Correlation of serum Mg levels and cardiac digitalis intoxication.
        Am J Cardiol. 1974; 33: 225-229
        • Billman G.E.
        • Hoskins R.S.
        Prevention of ventricular fibrillation with Mg sulfate.
        Eur J Pharmacol. 1988; 158: 167-171
        • Boriss M.N.
        • Papa L.
        Mg: A discussion of its role in the treatment of ventricular dysrhythmia.
        Crit Care Med. 1988; 16: 292-293
        • Bos W.J.W.
        • Postma D.S.
        • vanDoormaal J.J.
        Magnesiuric and calciuric effects of terbutaline in man.
        Clin Sci. 1988; 74: 595-597
        • Broughton A.
        • Anderson I.R.M.
        • Bowden C.H.
        Mg-deficiency syndrome in burns.
        Lancet. 1968; : 156-1158
        • Buckley J.E.
        • Clark V.L.
        • Meyer T.J.
        • et al.
        Hypomagnesemia after cisplatin combination chemotherapy.
        Arch Intern Med. 1984; 144: 2347-2348
        • Caddell J.L.
        • Suskind R.
        • Sillup H.
        • et al.
        Parenteral Mg load evaluation of malnourished Thai children.
        J Pediatr. 1973; 83: 129-135
        • Caddell J.L.
        • Reed G.F.
        Unreliability of plasma Mg values in asphyxiated neonates.
        Magnesium. 1989; 8: 11-16
        • Cardenas-Rivero N.
        • Chernow B.
        • Stoiko M.A.
        • et al.
        Hypocalcemia in critically ill children.
        J Pediatr. 1989; 114: 946-951
        • Chadda K.H.
        • Lichstein E.
        • Gupta P.
        Hypomagnesemia and refractory cardiac arrhythmia in a nondigitalized patient.
        Am J Cardiol. 1973; 31: 98-100
        • Chernow B.
        • Smith J.
        • Rainey T.
        • et al.
        Hypomagnesemia: Implications for the critical care specialist.
        Crit Care Med. 1982; 10: 193-196
        • Chernow B.
        • Zaloga G.
        • McFadden E.
        • et al.
        Hypocalcemia in critically ill patients.
        Crit Care Med. 1982; 10: 848-851
        • Chernow B.
        • Roa J.
        • Eguiguren L.
        • et al.
        Ultrafilterable Mg concentrations in critically ill children.
        Circ Shock. 1989; 27: 323
        • Chernow B.
        • Bamberger S.
        • Stoiko M.
        • et al.
        Hypomagnesemia in patients in postoperative intensive care.
        Chest. 1989; 95: 391-397
        • Chipperfield B.
        • Chipperfield J.R.
        Heart-muscle Mg, potassium, and zinc concentrations after sudden death from heart disease.
        Lancet. 1973; : 293-295
        • Chrysant S.G.
        • Ganousis L.
        • Chrysant C.
        Hemodynamic and metabolic effects of hypomagnesemia in spontaneously hypertensive rats.
        Cardiology. 1988; 75: 81-89
        • Cloherty J.P.
        • Stark A.R.
        Manual of Neonatal Care. Little Brown, Boston1989
        • Cockburn F.
        • Brown J.K.
        • Belton N.R.
        • et al.
        Neonatal convulsions associated with primary disturbance of calcium, phosphorus, and Mg metabolism.
        Arch Dis Child. 1973; 48: 99-108
        • D’Costa M.
        • Cheng P.T.
        Ultrafilterable calcium and Mg in ultrafiltrates of serum prepared with the Amicon MPS-1 system.
        Clin Chem. 1982; 29: 519-522
        • DeCarli C.
        • Sprouse G.
        • LaRosa J.C.
        Serum Mg levels in symptomatic atrial fibrillation and their relation to rhythm control by intravenous digoxin.
        Am j Cardiol. 1986; 57: 956-959
        • Dickerson R.N.
        • Brown R.O.
        Hypomagnesemia in hospitalized patients receiving nutritional support.
        Heart Lung. 1985; 14: 561-569
        • Dudin K.I.
        • Teebi A.S.
        Primary hypomagnesaemia.
        Eur J Pediatr. 1987; 146: 303-305
        • Dunnett J.
        • Nayler W.G.
        Calcium efflux from cardiac sarcoplasmic reticulum: Effects of calcium and Mg.
        J Mol Cell Cardiol. 1978; 10: 487-498
        • Durlach J.
        • Durlach V.
        Speculations on hormonal controls of Mg homeostasis: A hypothesis.
        Magnesium. 1984; 3: 109-131
        • Dyckner T.
        Serum Mg in acute myocardial infarction.
        Acta Med Scand. 1980; 207: 59-66
        • Dyckner T.
        • Wester P.O.
        Intra-/extracellular shifts of potassium after the administration of Mg in patients with cardiovascular diseases.
        Magnesium. 1984; 3: 339-345
        • Dyckner T.
        • Wester P.O.
        • Widman L.
        Amiloride prevents thiazide-induced intracellular potassium and Mg losses.
        Acta Med Scand. 1988; 224: 25-30
        • Edmondson H.A.
        • Berne C.J.
        • Homann R.E.
        • et al.
        Calcium, potassium, Mg and amylase disturbances in acute pancreatitis.
        Am J Med. 1952; 12: 34-42
        • Elin R.J.
        Assessment of Mg status.
        Clin Chem. 1987; 33: 1965-1970
        • Elin R.J.
        Mg metabolism in health and disease.
        Dis Mon. 1988; 34: 166-218
        • Engel R.R.
        • Elin R.J.
        Hypermagnesemia from birth asphyxia.
        J Peds. 1970; 77: 631-637
        • Fiaccodori E.
        • delCanale S.
        • Coffrini E.
        • et al.
        Muscle and serum Mg in pulmonary intensive care unit patients.
        Crit Care Med. 1988; 16: 751-760
        • Flatman P.W.
        • Lew V.L.
        The magnesium dependence of sodium pump-mediated sodium-potassium and sodium-sodium exchange in intact human red cells.
        J Physiol. 1981; 315: 421-446
        • Flatman P.W.
        Mg transport across cell membranes.
        J Membrane Biol. 1984; 80: 1-14
        • Flink E.B.
        • Stutzman F.L.
        • Anderson A.R.
        • et al.
        Mg deficiency after prolonged parenteral fluid administration and after chronic alcoholism complicated by delirium tremens.
        J Lab Clin Med. 1954; 43: 169-183
        • Fort P.
        • Lifshitz F.
        • Wapnir I.L.
        • et al.
        Mg metabolism in experimental diabetes mellitus.
        Diabetes. 1977; 26: 882-886
        • Freeman J.B.
        • Wittine M.F.
        Mg requirements are increased during total parenteral nutrition.
        Surg Forum. 1979; 30: 61-62
        • Friedman M.
        • Hatcher G.
        • Watson L.
        Primary hypomagnesaemia with secondary hypocalcemia in an infant.
        Lancet. 1967; 1: 703-705
        • Frizel D.
        • Malleson A.
        • Marks V.
        Plasma levels of ionized calcium and Mg in thyroid disease.
        Lancet. 1967; 1: 1360-1361
        • Fuss M.
        • Cogan C.
        • Gillet R.
        • et al.
        Mg administration reverses the hypocalcemia secondary to hypomagnesemia despite low circulating levels of 25-hydroxyvitamin D and 1,25-dyhydroxyvitamin D.
        Clin Endrocrinol. 1985; 22: 807-815
        • Garty R.
        • Alkalay A.
        • Bernheim J.L.
        Parathyroid hormone secretion and responsive ness to parathyroid hormone in primary hypomagnesemia.
        Isr J Med Sci. 1983; 19: 345348
        • Gerst P.H.
        • Porter M.R.
        • Fishman R.A.
        Symptomatic Mg deficiency in surgical patients.
        Ann Surg. 1964; 159: 402-406
        • Ghani M.F.
        • Smith J.R.
        The effectiveness of Mg chloride in the treatment of ventricular tachyarrhythmias due to digitalis intoxication.
        Am Heart J. 1974; 88: 621-626
        • Giles M.M.
        • Laing I.A.
        • Elton R.A.
        • et al.
        Mg metabolism in preterm infants: Effects of calcium, Mg, and phosphorus, and of postnatal and gestational age.
        J Pediatr. 1990; 117: 147-154
        • Goldman A.S.
        • Van Fossan D.D.
        • Baird E.E.
        Mg deficiency in celiac disease.
        Pediatrics. 1962; : 948-952
        • Gottlieb S.S.
        Importance of Mg in congestive heart failure.
        Am J Cardiol. 1989; 63: 39G-42G
        • Grant J.P.
        Handbook of Total Parenteral Nutrition. WB Saunders, Philadelphia1980
        • Green C.G.
        • Doershuk C.F.
        • Stern R.C.
        Symptomatic hypomagnesemia in cystic fibrosis.
        J Pediatr. 1985; 107: 425-428
        • Grubbs R.D.
        • Maguire M.E.
        Mg as a regulatory cation: Criteria and evaluation.
        Magnesium. 1987; 6: 113-127
        • Grubbs R.D.
        • Wetherill C.A.
        • Kutschke K.
        • et al.
        Mg transport in murine S49 lymphoma cells: Pharmacology and divalent cation selectivity.
        Am J Physiol. 1985; 248: C51-C57
        • Gunther T.
        Biochemistry and pathobiochemistry of Mg.
        Artery. 1981; 9: 167-191
        • Gupta R.K.
        • Gupta P.
        • Moore R.D.
        NMR studies of intracellular metal ions in intact cells and tissues.
        Ann Rev Biophys Bioeng. 1984; 13: 221-246
        • Halmi K.A.
        • Halmi N.A.
        • Anderson D.J.
        Effects of ions on adrenocorticotropin-sensitive adenylate cyclase of rat adrenals (38350).
        Proc Soc Exp Biol Med. 1974; 147: 399-402
        • Harris C.A.
        • Burnatowska M.A.
        • Sutton R.A.
        • et al.
        Effects of parathyroid hormone on electrolyte transport in the hampster nephron.
        Am J Physiol. 1979; 236: F342-F348
        • Haury V.G.
        Blood serum Mg in bronchial asthma and its treatment by the administration of Mg sulfate.
        J Lab Clin Med. 1940; 25: 340-344
        • Heaton F.E.
        • Pyrah L.N.
        • Beresford C.C.
        • et al.
        Hypomagnesemia in chronic alcoholism.
        Lancet. 1962; : 802-805
        • Hirschfelder A.D.
        • Haury V.G.
        Clinical manifestations of high and low plasma Mg.
        JAMA. 1934; 102: 1138-1141
        • Hollifield J.W.
        Potassium and Mg abnormalities: Diuretics and arrhythmias in hypertension.
        Am J Med. 1984; : 28-32
        • Hollifield J.W.
        Thiazide treatment of systemic hypertension: Effects of serum Mg and ventricular ectopic activity.
        Am J Cardiol. 1989; 63: 22G-25G
        • Iseri L.T.
        • French J.A.
        Mg: Nature’s physiologic calcium blocker.
        Am Heart T. 1984; 108: 188-193
        • Iseri L.T.
        • Fairshter R.D.
        • Hardemann J.L.
        Mg and potassium therapy in multifocalatrial tachycardia.
        Am Heart J. 1985; 110: 789-794
        • Iseri L.T.
        • Allen B.J.
        • Brodsky M.A.
        Mg therapy of cardiac arrhythmias in critical care medicine.
        Magnesium. 1989; 8: 299-306
        • Joffres M.R.
        • Reed D.M.
        • Yano K.
        Relationship of Mg intake and other dietary factors on blood pressure: The Honolulu heart study.
        Am J Clin Nutr. 1987; 45: 469-475
        • Johnson C.J.
        • Peterson D.R.
        • Smith E.K.
        Myocardial tissue concentrations of Mg and potassium in men dying suddenly from ischemic heart disease.
        Am J Clin Nutr. 1979; 32: 967-970
        • Jones J.E.
        • Desper P.C.
        • Shane S.R.
        Mg metabolism in hyperthyroidism and hypothyroidism.
        J Clin Invest. 1966; 45: 891-900
        • Jukarainen E.
        Plasma Mg levels during the first 5 days of life.
        Acta Paediatr Scand. 1971; 222: 5-58
        • June C.H.
        • Thompson C.B.
        • Kennedy M.S.
        Correlation of hypomagnesemia with the onset of cyclosporine-associated hypertension in marrow transplant patients.
        Transplantation. 1986; 41: 47-51
        • Kafka H.
        • Langevin L.
        • Armstrong P.W.
        Serum Mg and potassium in acute myocardial infarction.
        Arch Intern Med. 1987; 147: 465-469
        • Kes P.
        • Reiner Z.
        Symptomatic hypomagnesemia associated with gentamicin therapy.
        Mg Trace Elem. 1990; 9: 54-60
        • Khilnani P.
        • Munoz R.
        • Salem M.
        • et al.
        Hypomagnesemia and ionized hypocalcemia are prevalent findings in critically ill neonates.
        Chest. 1990; 98: 42S
        • Kristiansen V.B.
        • Larsen J.
        • Neilsen T.C.
        • et al.
        Correction of respiratory acidosis and transient hypomagnesemia.
        Acta Med Scand. 1985; 218: 133-135
        • Kruse H.S.
        • Orent E.R.
        • McCollum E.V.
        Studies on Mg deficiency in animals.
        J Biol Chem. 1932; 96: 519-539
        • Ku D.D.
        • An H.A.
        Mg deficiency produces endothelium-dependent vasorelaxation in canine coronary arteries.
        J Pharmacol Exp Ther. 1987; 241: 961-966
        • Kulick D.L.
        • Hong R.
        • Ryzen E.
        • et al.
        Electrophysiologic effects of intravenous Mg in patients with normal conduction systems and no clinical evidence of significant cardiac disease.
        Am Heart J. 1988; 115: 367-373
        • Leroy J.
        Necessity of Mg for life (in French).
        Comp Rend Soc Biol. 1926; 94: 431-434
        • Lewis D.L.
        • Lechleiter J.D.
        • Lin D.
        • et al.
        Intracellular regulation of ion channels in cell membranes.
        Mayo Clin Proc. 1990; 65: 1127-1143
        • Lim P.
        • Jacob E.
        Mg deficiency in patients on long-term diuretic therapy for heart failure.
        Br Med J. 1972; 3: 620-622
        • Loeb H.
        • Pietras E.J.
        • Gunnar R.M.
        • et al.
        Paroxysmal ventricular fibrillation in two patients with hypomagnesemia.
        Circulation. 1968; 37: 210-215
        • Loeb J.
        On the different effect of ions upon myogenic and neurogenic rhythmical contractions and upon embryonic and muscular tissues.
        Am J Physiol. 1900; 3: 383-396
        • Luthringer C.
        • Rayssiguier Y.
        • Gueux E.
        • et al.
        Effect of moderate Mg deficiency on serum lipids, blood pressure, and cardiovascular reactivity in normotensive rats.
        Br J Nutr. 1988; 59: 243-250
        • Macbeth R.A.
        • Mabbott J.D.
        Mg balance in the postoperative patient.
        Surg Gynecol Obstet. 1964; 116: 748-760
        • MacManus J.
        • Heaton F.W.
        The effect of Mg deficiency on calcium homeostasis in the rat.
        Clin Sci. 1969; 36: 297-306
        • Matuura T.
        • Kohno M.
        • Kanayama Y.
        • et al.
        Decreased intracellular free Mg in erythrocytes of spontaneously hypertensive rats.
        Biochem Biophys Res Commun. 1987; 143: 1012-1017
        • Martin B.J.
        • Milligan K.
        Diuretic-associated hypomagnesemia in the elderly.
        Arch Intern Med. 1987; 147: 1768-1771
        • Martin B.J.
        • McAlpine J.K.
        • Devine B.L.
        Hypomagnesaemia in elderly digitalized patients.
        Scott Med J. 1988; 33: 273-274
        • Matsuda H.
        • Saiguse A.
        • Irisawa H.
        Ohmic conductance through the inwardly rectifying K channel and blocking by internal Mg.
        Nature. 1987; 325: 156-158
        • Matzkin H.
        • Lotan D.
        • Boichis H.
        Primary hypomagnesemia with a probable double Mg transport defect.
        Nephron. 1989; 52: 83-86
        • McLellan B.A.
        • Reir S.R.
        • Lane P.L.
        Massive blood transfusion causing hypomagnese mia.
        Crit Care Med. 1984; 12: 146-147
        • McNair P.
        • Christensen M.S.
        • Christiansen C.
        • et al.
        Renal hypomagnesemia in human diabetes mellitus: Its relation to glucose homeostasis.
        Eur J Clin Invest. 1982; 12: 81
        • McNarmara R.M.
        • Spivey W.H.
        • Skobeloff E.
        • et al.
        Intravenous Mg sulfate in the man agement of acute respiratory failure complicating asthma.
        Ann Emerg Med. 1989; 18: 197-199
        • Miller J.F.
        Tetany due to deficiency in Mg.
        Am J Dis Child. 1944; 67: 117-119
        • Molioy D.W.
        • Dhingra S.
        • Sloven F.
        • et al.
        Hypomagnesemia and respiratory muscle power.
        Am Rev Respir Dis. 1984; 129: 497-498
        • Montgomery R.D.
        Mg metabolism in infantile protein malnutrition.
        Lancet. 1960; : 74-75
        • Montgomery R.D.
        Mg balance studies in marasmic kwashiorkor.
        J Pediatr. 1961; 59: 119-123
        • Morrissey J.J.
        • Cohn D.V.
        The effects of Ca and Mg on the secretion of parathormone and parathyroid secretory protein by isolated porcine parathyroid cells.
        Endocrinology. 1978; 103: 2081-2090
        • Motoyama T.
        • Dano H.
        • Fukuzaki H.
        Oral Mg supplementation in patients with essential hypertension.
        Hypertension. 1989; 13: 227-232
        • Murphy E.
        • Steenbergen C.
        • Levey L.A.
        Cytosolic free Mg levels in ischemic rat heart.
        J Biol Chem. 1989; 264: 5622-5627
        • Neff M.S.
        • Mendelssohn S.
        • Kin K.
        • et al.
        Mg sulfate in digitalis toxicity.
        Am J Cardiol. 1972; 29: 377-382
        • Nelson N.
        • Finnstrom O.
        • Larsson L.
        Neonatal hyperexcitability in relation to plasma ionized calcium, Mg, phosphate and glucose.
        Acta Pediatr Scand. 1987; 76: 579-584
        • Nishio A.
        • Gebrewold A.
        • Altura B.
        • et al.
        Comparative effects of Mg salts on reactivity of arterioles and venules to constrictor agents: An in situ study on microcirculation.
        J Pharmacol Exp Ther. 1988; 246: 859-865
        • Okayama H.
        • Aikawa T.
        • Okayama M.
        • et al.
        Bronchodilating effect of intravenous Mg sulfate in bronchial asthma.
        JAMA. 1987; 257: 1076-1078
        • Paymaster N.J.
        Postoperative Mg deficiency.
        Br J Anesth. 1975; 47: 85-88
        • Petersen V.P.
        Potassium and Mg turnover in Mg deficiency.
        Acta Med Scand. 1963; 174: 595-604
        • Quamme G.S.
        Effect of furosemide on calcium and Mg transport in the rat nephron.
        Am J Physiol. 1981; 241: F340-F347
        • Quamme G.S.
        Effect of hypercalcemia on renal tubular handling of calcium and Mg.
        Can J Physiol Pharmacol. 1982; 60: 1275-1280
        • Quamme G.A.
        • Dirks J.H.
        Renal Mg transport.
        Rev Physiol Biochem Pharmacol. 1983; 97: 69-105
        • Quamme G.A.
        • Dirks J.H.
        Mg metabolism.
        in: Maxwell M.G. Kleeman C.R. Narins R.G. Disorders of Fluid and Electrolyte Metabolism. McGraw Hill, New York1987: 297-316
        • Ralston S.
        • Boyle I.T.
        • Cowam R.A.
        • et al.
        PTH and vitamin D responses during treatment of hypomagnesaemic hypoparathyroidism.
        Acta Endocrinol. 1983; 103: 535-538
        • Ralston M.A.
        • Murnana M.R.
        • Kelley R.E.
        • et al.
        Mg content of serum, circulating mononuclear cells, skeletal muscle in congestive heart failure.
        Circulation. 1989; 80: 573580
        • Rasmussen H.S.
        • McNair P.
        • Noregard P.
        • et al.
        Intravenous Mg in acute myocardial infarction.
        Lancet. 1986; 1: 234-235
        • Rasmussen H.S.
        • Aurup P.
        • Hojberg S.
        • et al.
        Mg and acute myocardial infarction.
        Arch Intern Med. 1986; 146: 872-874
        • Rasmussen H.S.
        • McNair P.
        • Goransson L.
        • et al.
        Mg deficiency in patients with ischemic heart disease with and without acute myocardial infarction uncovered by an intravenous loading test.
        Arch Intern Med. 1988; 148: 329-332
        • Rasmussen H.S.
        • Cintin C.
        • Aurup P.
        • et al.
        The effect of intravenous Mg therapy on serum and urine levels of potassium, calcium, and sodium in patients with ischemic heart disease, with and without myocardial infarction.
        Arch Intern Med. 1988; 148: 1801-1805
        • Rasmussen H.S.
        Clinical intervention studies on Mg in myocardial infarction.
        Magnesium. 1989; 8: 316-325
        • Rasmussen H.S.
        • Thomsen P.E.
        The electrophysiological effects of intravenous Mg on human sinus node, atrioventricular node, atrium, and ventricle.
        Clin Cardiol. 1989; 12: 85-90
        • Rasmussen H.S.
        • Aurup P.
        • Goldstein K.
        • et al.
        Influence of Mg substitution therapy on blood lipid composition in patients with ischemic heart disease.
        Arch Intern Med. 1989; 149: 1050-1053
        • Rehak N.N.
        • Chlang B.T.
        Modified Mg method in the aca III: Elimination of interference by bilirubin.
        Clin Chem. 1989; 35: 1031-1033
        • Reinhart R.
        Mg metabolism: A review with special reference to the relationship between intracellular content and serum levels.
        Arch Intern Med. 1988; 148: 2415-2420
        • Resnick L.M.
        • Gupta R.K.
        • Laragh J.H.
        Intracellular free Mg in erythrocytes in essential hypertension: Relation to blood pressure and serum divalent cations.
        Med Sci. 1984; 81: 6511-6515
        • Roden D.
        Mg treatment of ventricular arrhythmias.
        Am J Cardiol. 1989; 63: 43G-46G
        • Rolla G.
        • Bucca C.
        • Caria E.
        • et al.
        Acute effect of intravenous Mg sulfate on airway obstruction of asthmatic patients.
        Ann Allergy. 1988; 61: 388-391
        • Rude R.K.
        • Monoogian C.
        • Ehrlich L.
        • et al.
        Mechanisms of blood pressure regulation by Mg in man.
        Magnesium. 1989; 8: 266-273
        • Rude R.K.
        Pathophysiology of Mg metabolism and the important role of Mg in potassium deficiency.
        Am J Cardiol. 1989; 63: 31G-34G
        • Ryzen E.
        • Wagners P.W.
        • Singer F.R.
        • et al.
        Mg deficiency in a medical ICU population.
        Crit Care Med. 1985; 13: 19-21
        • Ryzen E.
        • Elkayam U.
        • Rude R.K.
        Low blood mononuclear cell Mg in intensive cardiac care unit patients.
        Am Heart J. 1986; 111: 475-480
        • Salem M.
        • Kasinski N.
        • Andrei A.
        • et al.
        Hypomagnesemia is a frequent finding in emergency room patients with chest pain.
        Chest. 1990; 98: 103S
        • Savage D.C.
        • McAdam W.A.
        Convulsions due to hypomagnesemia in an infant recovering from diarrhea.
        Lancet. 1967; : 234-236
        • Schipperheyn J.J.
        The pathophysiology of potassium and Mg disturbances.
        Drugs. 1984; 28: 112-119
        • Seelig M.S.
        Mg requirements in human nutrition.
        J Med Soc New Jersey. 1982; 79: 849-850
        • Seelig M.S.
        Cardiovascular consequences of Mg deficiency and loss: Pathogenesis, prevalence and manifestations—Mg and chloride loss in refractory potassium repletion.
        Am J Cardiol. 1989; 63: 4G-21G
        • Seller R.H.
        • Cangiano J.
        • Kim K.E.
        • et al.
        Digitalis toxicity and hypomagnesemia.
        Am Heart J. 1970; 79: 58-67
        • Shah G.M.
        • Alvarado P.
        • Kirschenbaum M.A.
        Symptomatic hypocalcemia and hypomagnesemia with renal Mg wasting associated with pentamidine therapy in a patient with AIDS.
        Am J Med. 1990; 89: 380-382
        • Shattock M.J.
        • Hearse D.J.
        • Fry C.H.
        The ionic basis of the anti-ischemic and anti-arrhythmic properties of Mg in the heart.
        J Am Coll Nutr. 1987; 6: 27-33
        • Sheehan j.
        • White A.
        Diuretic-associated hypomagnesemia.
        Br Med J. 1982; 285: 1157-1159
        • Shils M.E.
        Mg, calcium, and parathyroid hormone interactions.
        Ann NY Acad Sci. 1980; : 165-178
        • Sjogren A.
        • Floren C.H.
        • Nilsson A.
        Mg and potassium status in healthy subjects as assessed by analysis of Mg and potassium in skeletal muscle biopsies and Mg in mononuclear cells.
        Magnesium. 1987; 6: 91-99
        • Specter M.J.
        • Schweizer E.
        • Goldman R.
        Studies on Mg mechanism of action in digitalis-induced arrhythmias.
        Circulation. 1975; 52: 1001-1005
        • Speich M.
        • Bousquet B.
        • Nicolas G.
        Concentrations of Mg, calcium, potassium, and sodium in human heart muscle after acute myocardial infarction.
        Clin Chem. 1980; 12: 1662-1665
        • Speich M.
        • Gelot S.
        • Robinet N.
        • et al.
        Changes in Mg, zinc, and calcium in men and women after acute myocardial infarction.
        Clin Chim Acta. 1987; 168: 19-26
        • Steinberg S.F.
        • Chow Y.K.
        • Bilezikian J.P.
        Regulation of rat heart membrane adenylate cyclase by Mg and manganese.
        J Pharmacol Exp Ther. 1986; 237: 764-772
        • Storstein O.
        • Hansteen V.
        • Hatle L.
        • et al.
        Studies on digitalis.
        Acta Med Scand. 1977; 202: 445-447
        • Strickberger S.A.
        • Miller C.B.
        • Levine J.G.
        Multifocal atrial tachycardia from electrolyte imbalance.
        Am Heart J. 1988; 115: 680-681
        • Suh S.M.
        • Csima A.
        • Fraser D.
        Pathogenesis of hypocalcemia in Mg depletion.
        J Clin Invest. 1971; 50: 2668-2678
        • Tsang R.C.
        Neonatal Mg disturbances.
        Am J Dis Child. 1972; 124: 282-293
        • Turlapaty P.D.
        • Altura B.M.
        Mg deficiency produces spasms of coronary arteries: Relationship to etiology of sudden death ischemic heart disease.
        Science. 1980; 208: 198-200
        • Turlapaty P.D.
        • Weiner R.
        • Altura R.M.
        Interactions of Mg and verapamil on tone and contractility of vascular smooth muscle.
        Eur J Pharmacol. 1981; 74: 263-272
        • Turnier E.
        • Osborn J.J.
        • Gerbode F.
        • et al.
        Mg and open-heart surgery.
        J Thorac Cardiovasc Surg. 1972; 64: 694-705
        • Van Gaal L.
        • Delvigne C.
        • Vandewoude M.
        • et al.
        Evaluation of Mg before and after jejuno-ileal versus gastric bypass surgery for morbid obesity.
        J Am Coll Nutr. 1987; 6: 397-400
        • Walker G.M.
        Mg and cell cycle control: An update.
        Magnesium. 1986; 5: 9-23
        • Watanabe S.
        • Dreifus L.S.
        Electrophysiological effects of Mg and its interactions with potassium.
        Cardiovasc Res. 1972; 6: 79-88
        • Weaver K.
        Pregnancy-induced hypertension and low birth weight in Mg-deficient ewes.
        Magnesium. 1986; 5: 191-200
        • Werner J.
        • Pintar K.
        • Simon M.A.
        • et al.
        The effects of prolonged hypomagnesemia on the cardiovascular system in young dogs.
        Am Heart J. 1964; 67: 221-231
        • Whang R.
        • Ryan M.
        • Orndorff M.
        Relationship of hypermagnesemia and hyperkalemia to muscle Mg and K in acute and chronic azotemia in the rat.
        Metabolism. 1973; 22: 23-28
        • Whang R.
        • Chrysant S.
        • Dillard R.
        • et al.
        Hypomagnesemia and hypokalemia in 1000 treated ambulatory hypertensive patients.
        J Am Coll Nutr. 1982; 1: 317-322
        • Whang R.
        • Oei T.O.
        • Aikawa J.K.
        • et al.
        Predictors of clinical hypomagnesemia.
        Arch Intern Med. 1984; 144: 1794-1796
        • Whang R.
        • Flink E.R.
        • Dyckner T.
        • et al.
        Mg depletion as a cause of refractory potassium depletion.
        Arch Intern Med. 1985; 145: 1686-1689
        • Whelton P.K.
        • Klag M.J.
        Mg and blood pressure: Review of the epidemiologic and clinical trial experience.
        Am J Cardiol. 1989; 63: 26G-30G
        • White R.E.
        • Hartzell H.G.
        Effects of intracellular free Mg on calcium current in isolated cardiac myocytes.
        Science. 1988; 239: 778-780
        • White R.E.
        • Hartzell H.G.
        Mg ions in cardiac function, regulator of ion channels and second messengers.
        Biochem Pharmacol. 1989; 38: 859-867
        • Wong H.B.
        • Teh Y.F.
        An association between serum Mg and tremor and convulsions in infants and children.
        Lancet. 1968; : 19-21
        • Wong E.T.
        • Rude R.K.
        • Singer F.R.
        • et al.
        A high prevalence of hypomagnesemia and hypermagnesemia in hospitalized patients.
        Am J Clin Pathol. 1983; 79: 348-352
        • Wynn A.
        • Wynn M.
        Mg and other nutrient deficiencies as possible causes of hypertension and low birth weight.
        Nutr Health. 1988; 6: 69-88
        • Zaloga G.P.
        • Chernow B.
        • Pock A.
        • et al.
        Hypomagnesemia is a common complication of aminoglycoside therapy.
        Surg Gynecol Obstet. 1984; 158: 561-565
        • Zaloga G.P.
        • Wilkens R.
        • Tourville J.
        • et al.
        A simple method for determining physiologically active calcium and Mg concentrations in critically ill patients.
        Crit Care Med. 1987; 15: 813-815
        • Zaloga G.P.
        • Chernow B.C.
        Divalentions: Calcium, Mg, and phosphorus.
        in: Chernow B. The Pharmacologic Approach to the Critically Ill Patient. Williams and Wilkins, Baltimore1988: 603-636

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      DOI: https://doi.org/10.1016/S0749-0704(18)30334-8

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