Značaj praćenja nivoa jonizovane frakcije magnezijuma u krvi kod kritično obolelih pacijenata
Sažetak
Uvod: Kritične bolesti podrazumevaju disfunkcije vitalnih organa i visok rizik od pretećeg smrtnog ishoda. Magnezijum je bioesencijalni mineral sa višestrukim fiziološkim dejstvima značajnim za rad vitalnih organa. Magnezijum stabilizuje ekscitabilne membrane, doprinoseći pravilnoj neuromišićnoj, kardiovaskulnoj i respiratornoj funkciji. Jonizovani Mg2+ (iMg2+) je slobodni bioaktivni oblik Mg2+ u telesnim tečnostima. Poremećaji Mg2+ statusa kritično obolelih pacijenata često se zanemaruju. Hronični deficit Mg2+ je sve učestaliji u opštoj populaciji. Predstavlja značajan faktor ukupnog morbiditeta i mortaliteta kritično obolelih.
Metode: Izvršena je elektronska pretraga bibliotečke baze podataka PubMed bez vremenskih ograničenja (zaključno sa 8. novembrom 2024), korišćenjem ključnih reči »jonizovani magnezijum« I »kritični pacijenti« za identifikaciju studija koje su ispitivale vrednost merenja koncentracije jonizovane frakcije magnezijuma u krvi pacijenata sa kritičnim poremećajima zdravlja. Kriterijumi za odabir uključivali su samo studije na humanoj, a isključivali studije na veterinarskoj populaciji.Rezultati: Budući da je Mg2+ dominantno intracelularni katjon, nedostatak Mg2+ u organizmu nije lako utvrditi. U početnim stadijumima postoji klinički neispoljen tkivni deficit Mg2+ u prisustvu normalne jonizovane i totalne magnezijemije. Neslaganje između nivoa iMg2+ i totalnog Mg2+ u krvi često je prisutno kod kritično obolelih. Koncentracija frakcije iMg2+ predstavlja specifičniji marker opšteg statusa Mg2+ od totalnog Mg2+. Neophodan je odgovarajući elektrolitni analizator za esej određivanja iMg2+ u cilju brze i adekvatne procene Mg2+ statusa, i procene potrebe za nadoknadom Mg2+ u slučaju nedostatka.
Zaključak: Abnormalnosti nivoa Mg2+ su česte u kritičnih pacijenata. Teži poremećaji mogu dovesti do vitalne ugroženosti. Praćenje nivoa iMg2+ za procenu Mg2+ statusa omogućava dijagnostikovanje i korigovanje poremećaja Mg2+, a time i bolju prognozu ishoda bolesti.Reference
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