Jurnal Respirologi Indonesia
Vol 43, No 3 (2023)

Magnesium and Phosphate Ion Levels in Mechanically Ventilated Patients Treated at Persahabatan Hospital’s Intensive Care Unit (ICU) and Respiratory Intensive Care Unit (RICU) in 2018

Filemon Suryawan Handjaja (Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia)
Menaldi Rasmin (Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia)
Prasenohadi Prasenohadi (Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia)
Ernita Akmal (Anesthesiology Functional Medical Staff, Intensive Care Installation, Persahabatan Hospital)



Article Info

Publish Date
31 Jul 2023

Abstract

Background: History shows that respiratory system has a long and complicated arrangement so that many factors can affect a human’s ability to breathe. Some electrolytes often considered as most important are sodium (Na+), potassium (K+), calcium (Ca2+) and chloride (Cl-). Other than that, magnesium (Mg2+) and phosphate (PO43-) are also important in all processes, especially at the neuromuscular junction and in muscle cells as adenosine triphosphate (ATP). Some researchers have found that PO43- affected patients’ clinical condition and ventilator weaning success, although Mg2+ gave inconsistent results. Until now, there have not been any studies or data about the significance of Mg2+ and PO43- in ventilator weaning in Indonesia.Methods: This was a cross sectional study with total sampling. A vein blood sample was taken after ICU/RICU admission at Persahabatan Hospital. Blood sample was taken consecutively until it reached a minimum of 30 subjects (pilot study). All patients found with mechanical ventilation were included, except for patients with complicated procedure (e.g. avian influenza, multidrug-resistant tuberculosis). Blood sample was analyzed for Mg2+, inorganic phosphate (Pi) and other additional tests. Failure in weaning was defined as reintubation within 48 hours after extubation or failure in the spontaneous breathing trial (SBT).Results: Of the 31 subjects evaluated, there were 3 patients with weaning failure. The median Mg2+ value was 0.5 (0.5-2.6) in successfully weaned patients and 0.6 (0.6-2.7) in patients with weaning failure, lower than its normal value. The mean Pi value was 4.21±1.17 (normal value) in successfully weaned patients and 5.43±0.47 (high value) in patients with weaning failure. Further analysis found that no significant relation was found between weaning and patient’s characteristics other than heart rate and Ca2+, although it was not clear if there were some biases which could affect these results. Low Mg2+ value was observed in 23 subjects, no low Pi value was seen in all subjects, high Mg2+ value was found in 1 subject, high Pi value was observed in 11 subjects, and the rest was in the normal range.Conclusion: The median Mg2+ value in both weaning groups (successful and failed) were below the normal limit at 0.5 (0.5-2.6) and 0.6 (0.6-2.7). Mean Pi value in the successful weaning group was 4.21±1.17 (within normal range), and the value in failed weaning group was 5.43±0.47 (above normal range).

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Journal Info

Abbrev

jri

Publisher

Subject

Health Professions Medicine & Pharmacology

Description

Jurnal Respirologi Indonesia (JRI) is an online and printed scientific publication of the Indonesian Society of Respirology (ISR). The journal is published thrice-monthly within a year (January, April, July and October). The journal is focused to present original article, article review, and case ...