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The relationship between ionized and total serum magnesium concentrations during abdominal surgery
Marcella J Lanzinger1, Eugene W Moretti, Robert F Wilderman
1Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA. lanzi001@mc.duke.edu
Study Objective:
To determine the necessity for ionized magnesium (iMg) assay by evaluating the effect of abdominal surgery without massive transfusion on total magnesium (Mg) and iMg concentrations.
Design:
Prospective, observational study.
Setting:
Operating rooms at a university teaching hospital.
Patients:
31 patients without electrolyte abnormalities who were scheduled for abdominal surgery.
Interventions:
None.
Measurements:
Serum electrolytes, iMg, ionized calcium, proteins before and after surgery, and urine Mg were recorded.
Main Results:
Total Mg and iMg decreased: Mg 23%, iMg 15%; p < 0.0001. Total and iMg were highly correlated (r = 0.728, p < 0.0001). Urine Mg output remained within normal limits (mean 0.24 mmol/hr).
Conclusions:
During abdominal surgery without massive transfusion, both total and ionized hypomagnesemia occur. Changes in iMg and total serum Mg concentrations are closely correlated. Total serum Mg assay, while overestimating the prevalence of ionized hypomagnesemia, is sufficient to screen for hypomagnesemia.