A Study of Hypomagnesemia in Patients Admitted in Medical ICU and Its Correlation with Final Outcome

Introduction: Magnesium is the second most common intracellular cation found in the body that is required as cofactor in numerous enzymatic reactions, smooth functioning of cardiac and neurological systems. Magnesium deficiency is often overlooked in critically ill patients and is linked with risk of electrolyte imbalance, difficulty weaning off ventilator, sudden cardiac deaths and poorer outcome. Objective- To assess prevalence of magnesium deficiency in critically ill patients admitted to Medical ICU and its association with requirement & duration of mechanical ventilation, ICU stay, APACHE-II & mortality. Methods- Prospective descriptive study was conducted on 69 critically ill patients admitted in medical ICU. After taking informed consent serum magnesium level of patients were collected and entered in spreadsheet and final analysis was done with help of Open EPI and SPSS software. Results-It was concluded that patients having hypomagnesemia were at increased risk of electrolyte abnormalities, longer ventilatory support, longer hospital and ultimately poorer outcome stay as compared to patients with normal magnesium levels. Conclusion- Magnesium remains an important but often side-lined cation in critically ill patients. However, Hypomagnesemia is a repeated finding seen in critically ill patients and is significantly associated with a higher mortality rate and frequent need for mechanical ventilation.

Walking blood banks: an immediate solution to rural India's blood drought

The current system of blood banks in India is such that rural patients are deprived of timely access to an adequate volume of life-saving blood, adding to preventable mortality. On the basis of an academic framework for a blood transfusion system, we describe an alternative approach in which rural practitioners utilise unbanked blood transfusions from a voluntary pool of pre-screened donors. This system would provide safe blood – as evidenced by international experience and limited projected increase in transfusion-transmissible infection in India – at a fraction of the financial cost imposed by the current system. Given the failing status quo and the undue burden placed on rural clinicians and patients to procure blood, it is imperative that policy-makers further explore the use of unbanked, direct blood transfusion for patients facing emergent, life-threatening haemorrhage