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Massive Transfusion Increases Serum Magnesium Concentration.

Justyna Malinowska1,2, Milena Małecka-Giełdowska1,3, Katarzyna Pietrucha4

  • 1Department of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland.

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|August 12, 2023
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Summary

Massive red blood cell transfusions increase patient serum magnesium levels, potentially due to mild hemolysis in transfused cells. This finding is crucial for managing transfusion complications.

Keywords:
RBChypomagnesemiamagnesiumtransfusion

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Area of Science:

  • Transfusion Medicine
  • Clinical Chemistry
  • Hematology

Background:

  • Massive transfusion of packed red blood cells (RBCs) is a critical intervention but can lead to complications like dysmagnesemia.
  • Magnesium, an intracellular ion, can be significantly impacted by transfused RBCs, affecting recipient blood magnesium levels.

Purpose of the Study:

  • To investigate the impact of massive blood transfusions on serum magnesium concentrations.
  • To explore the relationship between intracellular magnesium in RBCs and postoperative magnesium levels.

Main Methods:

  • Retrospective study of 49 patients receiving massive transfusions (≥4 units/h).
  • Analysis of laboratory results and patient history from hospital databases.
  • Measurement of intracellular magnesium concentration in 231 RBC samples using a colorimetric method.

Main Results:

  • Significant increases in mean serum magnesium observed 24h and 48h post-transfusion (p < 0.00001).
  • Patients who died had significantly higher serum magnesium concentrations (p < 0.05).
  • Median intracellular magnesium in RBCs (0.91 mmol/L) was below reference values (1.65-2.65 mmol/L).

Conclusions:

  • Transfused RBCs significantly elevate postoperative serum magnesium levels.
  • Mild hemolysis of transfused RBCs may contribute to increased serum magnesium, given the low intracellular concentration found.