Magnésium et réanimation

Magnesium plays an important role as a cofactor in many of the body's critical functions. Levels of magnesium are controlled by the kidneys and gastrointestinal tract. Magnesium deficiency is found in about 40% of critically ill patients and may complicate many diseases. Manifestations of magnesium deficiency include alteration in calcium and potassium homeostasis along with cardiac, neuromuscular and neuropsychiatric disorders. Its treatment consists of parenteral administration of magnesium and depends on the clinical setting. Hypermagnesemia is often iatrogenic. The first symptom is a diminution of deep tendon reflexes, then paralysis of voluntary muscles may produce quadriplegia or apnea. Peritoneal dialysis or hemodialysis may be required. Magnesium treatment is a viable therapeutic option when other antiarrhythmic agents fail to suppress numerous types of arrhythmias. Magnesium administration is a very effective and safe treatment for « torsade de pointesand for preeclampsia-eclampsia. Some results suggest that magnesium is a useful adjunct to the central nervous system depressants traditionally used in the treatment of severe tetanus induced autonomic dysfunction and in patients with moderate to severe asthma who show little improvement with β-agonists.