Objectives: To detect prevalence of hypomagnesemia in critically ill children , its association with sepsis and electrolyte abnormalities and to correlate this with mortality. Background: Hypomagnesemia is a significant and under-recognized electrolyte abnormality in critically ill children . It can lead to potentially fatal complications. Material and Methods: This is a cross over case control study done at the pediatric intensive care unit (PICU) of Menoufia university Hospital from April 2015 to May 2016. We studied 100 patients who met the inclusion criteria. Patients under the study were managed and treated according to their clinical status and took their supportive traditional treatment. Results: Prevalence of hypomagnesemia in critically ill pediatric patients was 59%. Patients with hypomagnesemia had longer ICU stay (10.16 days vs. 6.04 days, p value = 0.007), higher PRISM score (25.83 vs 19.68, p value <0.001), more frequent need for ventilation (76.3% vs. 36.6 %, p value <0.001), higher mortality (57.6% vs. 29.3% (p value = 0.008), higher incidence of electrolyte abnormalities like hypokalemia (62.71% vs. 34.14%, p = 0.004) and hypocalcemia (71.18 % vs. 41.46 %, p = 0.002) and more frequent association with sepsis (67.8% vs. 32.2%, p=< 0.001) than patients with normal magnesium level. By analysis of the Receiver operating characteristic curve (ROC curve), we found an area under the curve (AUC) of .638 for Mg for diagnosis of sepsis while C-reactive protein (CRP) had an AUC of.948. As regard prognosis, Mg had an AUC of 0.576 for prediction of mortality whereas the AUC for PRISM score was 0.811 and for CRP was 0.716. Logistic regression analysis showed that hypomagnesemia is a significant predictor for mortality among critically ill children (p value = 0.028) and OR = 3.180 (0.854-7.965). Conclusion: Hypomagnesemia is common and is associated with high incidence of morbidity and mortality in critically ill children so, routine monitoring is vital for timely diagnosis.
展开▼
