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IFCC guideline for sampling, measuring and reporting ionized magnesium in plasma
Mohammed C Ben Rayana1, Robert W Burnett, Arthur K Covington
1Department of Chemistry, University of Newcastle upon Tyne, UK.
Clinical Chemistry and Laboratory Medicine
|August 1, 2007
Summary
This guideline establishes a standard for measuring ionized magnesium (iMg) in plasma using ion-selective electrodes (ISEs). Adhering to these recommendations ensures comparable and unbiased iMg results for clinical applications.
Area of Science:
- Clinical Chemistry
- Analytical Chemistry
- Biomedical Engineering
Background:
- Ion-selective electrodes (ISEs) are used for measuring ionized magnesium (iMg) in plasma.
- Current methods may yield variable and biased iMg results, hindering clinical comparability.
- Accurate iMg measurement is crucial for physiological and clinical assessments.
Purpose of the Study:
- To provide an International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) guideline for standardized sampling, measurement, and reporting of iMg in plasma.
- To establish prerequisites for achieving comparable and unbiased iMg results using ISEs.
- To recommend a standardized reporting format for iMg concentration.
Main Methods:
- Recommends measuring iMg as a substance concentration relative to calibrants of physiological ionic strength.
- Advocates for simultaneous measurement of ionized calcium (Ca2+) to correct for interference with Mg-ISEs.
- Stresses the importance of simultaneous pH measurement for adjusting iMg results to pH 7.4 due to Mg binding dependency.
- Highlights the utility of blood-gas analyzers for point-of-care iMg testing using whole blood samples.
Main Results:
- The proposed guideline aims to standardize iMg measurement, leading to comparable and unbiased results.
- Reporting iMg as substance concentration will yield results approximately 3% higher than true substance concentration and 4% lower than true molality.
- Simultaneous measurement and correction for Ca2+ interference are necessary for accurate iMg determination.
- Simultaneous pH measurement allows for adjustment to a standard pH of 7.4.
Conclusions:
- This IFCC guideline provides a framework for consistent and accurate measurement of ionized magnesium in plasma.
- Standardized reporting and measurement protocols, including correction for calcium and pH, are essential for clinical utility.
- Point-of-care testing using whole blood offers advantages in minimizing turnaround time for iMg analysis.
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