Key messages

• Hypomagnesemia is very common in the critically ill and is associated with higher mortality and longer hospital stay.

• It has multiple causes including increased magnesium demand during illness, increased magnesium losses, and iatrogenic magnesium wasting and redistribution.

• Experimentally, magnesium-deficient animals have a higher mortality following endotoxin challenge which is reduced significantly by magnesium replacement.

• 1 mmol = 24 mg = 2 mEq of magnesium; 1 g MgSO4 = 4 mmol » 98 mg elemental magnesium.

• Daily requirements: 0.4 mEq/kg/day orally; 0.1 to 0.2 mEq/kg/day parenterally.

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