Hypermagnesemia

Hypermagnesemia describes a serum magnesium concentration> 2,6 mg / dl (> 1.05 mmol / l). The main cause is the insufficiency. The symptoms consist of hypotension, respiratory depression and cardiac arrest. The diagnosis is made by determining the serum concentration of magnesium. Treatment consists of i.v. Administration of calcium gluconate and furosemide. In severe cases, dialysis is required.

(See also overview of disorders of the magnesium concentration.)

Hypermagnesemia describes a serum magnesium concentration> 2,6 mg / dl (> 1.05 mmol / l). The main cause is the insufficiency. The symptoms consist of hypotension, respiratory depression and cardiac arrest. The diagnosis is made by determining the serum concentration of magnesium. Treatment consists of i.v. Administration of calcium gluconate and furosemide. In severe cases, dialysis is required. (See also overview of disorders of the magnesium concentration.) Symptomatic hypermagnesemia is very unusual. It occurs most commonly in patients with renal failure after taking magnesium-drugs such as antacids and laxatives. The symptoms and complaints are made hyperreflexia, hypotension, respiratory depression and cardiac arrest. Diagnostic serum magnesium concentrations> 2.6 mEq / L (> 1.05 mmol / l) In serum magnesium levels of 6-12 mg / dL (2.5-5 mmol / l) show an extension in the ECG of the PR interval, a broadening the QRS complex, and an increased amplitude of the T wave. Deep tendon reflexes disappear when the serum magnesium concentration reached 12 mg / dl (5.0 mmol / l). Hypotension, respiratory depression and loss of consciousness develop in further advancing hypermagnesemia. Cardiac arrest can occur when the blood magnesium concentration is> 15 mg / dl (6.0-7.5 mmol / l). Treatment calcium gluconate diuresis or dialysis The treatment of severe Magnesiumintoxikation includes measures to maintain respiration and circulation and the i.v. Administration of 10-20 ml of 10% calcium gluconate. Calcium gluconate affects many of the magnesium-induced lesions, especially respiratory depression, contrary. I.v. Furosemide can support the magnesium excretion when renal function is normal; the volume status should be maintained. Hemodialysis is a very useful method in a heavy hypermagnesemia, since a relatively large fraction (about 70%) of the magnesium in the blood is not protein bound and thus removed with hemodialysis. When hemodialysis is not feasible in an impairment of hemodynamics, peritoneal dialysis may be an alternative.

Health Life Media Team

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