Journal article
Preferences for the measurement and supplementation of magnesium, phosphate and zinc in ICUs: The international WhyTrace survey.
- Vesterlund GK Department of Intensive Care, Rigshospitalet University of Copenhagen, Copenhagen, Denmark.
- Ostermann M Department of Critical Care, King's College London, Guy's & St Thomas' Hospital, London, UK.
- Myatra SN Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.
- Arabi YM College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
- Sadat M College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
- Zampieri FG Research Institute, HCor-Hospital do Coração, São Paulo, Brazil.
- Cronhjort M Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
- Schefold JC Department of Intensive Care Medicine, Inselspital, University of Bern, Switzerland.
- Stöhr F Department of Intensive Care Medicine, Inselspital, University of Bern, Switzerland.
- Buanes EA Department of intensive care, Haukeland University Hospital, Bergen, Norway.
- Bäcklund M Department of Perioperative, Intensive Care and Pain Medicine, Helsinki University Hospital, Finland.
- Thormar KM Landspitali University Hospital, Reykjavik, Iceland.
- Perner A Department of Intensive Care, Rigshospitalet University of Copenhagen, Copenhagen, Denmark.
- 2020-11-09
Published in:
- Acta anaesthesiologica Scandinavica. - 2020
English
BACKGROUND
Patients admitted to the Intensive Care Unit (ICU) often have low magnesium, phosphate and zinc levels. Monitoring of serum concentrations and supplementation may be important, but there is no consensus on optimal practice. The objective of the WhyTrace survey was to describe current practice regarding the measurement and supplementation of magnesium, phosphate and zinc in ICUs.
METHODS
A 54-item electronic questionnaire was developed in accordance with SURGE, SUrvey Reporting GuidelinE, to address international clinical practice in the ICU. National investigators recruited ICUs in ten countries with one physician responding per ICU using a unique e-mail distributed survey-link.
RESULTS
The questionnaire was sent to clinicians in 336 ICUs of whom 283 (84%) responded. In 62% of the ICUs, a standard procedure was in place regarding the measurement of serum magnesium levels, in 58% for phosphate and in 9% for zinc. Zinc was never or rarely measured in 64% of ICUs. The frequency of requesting serum levels varied from twice daily to once weekly. Regarding supplementation, 66% of ICUs had a standard procedure for magnesium, 63% for phosphate and 15% for zinc. Most procedures recommended supplementation when serum levels were below the lower reference level, but some used the upper reference levels as the threshold for supplementation and others decided on a case-by-case basis.
CONCLUSION
The practice of measuring and supplementing magnesium, phosphate and zinc differed substantially between ICUs. Our findings indicate that there is a need for high-quality prospective data on frequencies of measurements, treatment goals and effects of supplementation on patient-important outcomes.
Patients admitted to the Intensive Care Unit (ICU) often have low magnesium, phosphate and zinc levels. Monitoring of serum concentrations and supplementation may be important, but there is no consensus on optimal practice. The objective of the WhyTrace survey was to describe current practice regarding the measurement and supplementation of magnesium, phosphate and zinc in ICUs.
METHODS
A 54-item electronic questionnaire was developed in accordance with SURGE, SUrvey Reporting GuidelinE, to address international clinical practice in the ICU. National investigators recruited ICUs in ten countries with one physician responding per ICU using a unique e-mail distributed survey-link.
RESULTS
The questionnaire was sent to clinicians in 336 ICUs of whom 283 (84%) responded. In 62% of the ICUs, a standard procedure was in place regarding the measurement of serum magnesium levels, in 58% for phosphate and in 9% for zinc. Zinc was never or rarely measured in 64% of ICUs. The frequency of requesting serum levels varied from twice daily to once weekly. Regarding supplementation, 66% of ICUs had a standard procedure for magnesium, 63% for phosphate and 15% for zinc. Most procedures recommended supplementation when serum levels were below the lower reference level, but some used the upper reference levels as the threshold for supplementation and others decided on a case-by-case basis.
CONCLUSION
The practice of measuring and supplementing magnesium, phosphate and zinc differed substantially between ICUs. Our findings indicate that there is a need for high-quality prospective data on frequencies of measurements, treatment goals and effects of supplementation on patient-important outcomes.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1111/aas.13738
- PMID 33165935
- Persistent URL
- https://sonar.ch/global/documents/53049
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