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Effect of magnesium supplementation on lactate clearance in critically ill patients with severe sepsis: a randomized clinical trial

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European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objectives

In this study, changes in lactate clearance following magnesium supplementation were evaluated in critically ill patients with severe sepsis.

Methods

Fifty-eight patients with severe sepsis were randomly assigned to receive either magnesium (n = 30) or placebo (n = 28). Patients in the magnesium group received intravenous magnesium sulfate to maintain serum magnesium level around 3 mg/dL for 3 days. The placebo group received the same volume of normal saline. Change in lactate clearance was considered primary outcome of the study.

Results

Mean increase in the lactate clearance in the magnesium group was significantly higher than the placebo group on day 2 (27.53% vs. 23.79% respectively, p < 0.001) and day 3 (49.83% vs. 37.02% respectively, p < 0.001). Time to lactate clearance was also significantly shorter in the magnesium group than the placebo group (47.28 ± 20.59 vs. 61.20 ± 24.31 h respectively, p = 0.03). Sepsis-related mortality was not significantly different but median length of ICU stay was significantly shorter in the magnesium group than the placebo group (8 vs. 15 days respectively, p < 0.01).

Conclusions

Magnesium supplementation increased lactate clearance in critically ill patients with severe sepsis. Optimizing serum magnesium level near the upper limit of the normal range may improve severe sepsis outcomes.

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Acknowledgments

Office of Vice-Chancellor for Research of Tehran University of Medical Sciences, Tehran, Iran, supported this work. We thank the general ICU nursing staff of Imam Khomeini Hospital for their kind support.

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Authors and Affiliations

  1. Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, P.O.Box: 14155/6451, Tehran, 1417614411, Iran

    Afsaneh Noormandi & Hossein Khalili

  2. Department of Intensive Care Unit, Imam Khomeini Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Mostafa Mohammadi

  3. Department of Pathology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Alireza Abdollahi

Authors
  1. Afsaneh Noormandi
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  2. Hossein Khalili
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  3. Mostafa Mohammadi
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  4. Alireza Abdollahi
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Contributions

Afsaneh Noormandi: Data gathering, data analysis, manuscript drafting

Hossein Khalili: Designing of study, data analysis, interpretation of results, final editing of manuscript

Mostafa Mohammadi: Patients’ selection, clinical interpretation of data

Alireza Abdollahi: Laboratory analysis

Corresponding author

Correspondence to Hossein Khalili.

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The authors declare that they have no conflict of interest.

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Noormandi, A., Khalili, H., Mohammadi, M. et al. Effect of magnesium supplementation on lactate clearance in critically ill patients with severe sepsis: a randomized clinical trial. Eur J Clin Pharmacol 76, 175–184 (2020). https://doi.org/10.1007/s00228-019-02788-w

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  • DOI: https://doi.org/10.1007/s00228-019-02788-w

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