AI Article Synopsis
- Many ICU patients show low levels of magnesium, phosphate, and zinc, but there's uncertainty about whether supplementing these minerals is beneficial or harmful.
- A systematic review of randomized clinical trials aimed to evaluate the impact of these supplements on adult ICU patients, focusing on mortality and mechanical ventilation duration.
- Findings indicated that while magnesium and zinc supplementation had potential benefits in reducing mortality, the evidence was considered very low in quality, highlighting the need for high-quality research to clarify the effectiveness of these supplements in critical care.
Article Abstract
Background: Low-serum levels of magnesium, phosphate, and zinc are observed in many intensive care unit (ICU) patients, but clinical equipoise exists regarding supplementation strategies. We aimed to assess the desirable and undesirable effects of supplementation with magnesium, phosphate, or zinc in adult ICU patients.
Methods: We conducted a systematic review with meta-analysis of randomised clinical trials assessing the effects of supplementation with magnesium, phosphate, or zinc in adult ICU patients. Primary outcomes were mortality and duration of mechanical ventilation. We registered the protocol, followed the Preferred Reporting Items for Systematic Review and Meta-Analysis statement, used the Cochrane risk of bias 2 tool, and the grading of recommendations, assessment, development and evaluation (GRADE) approach for assessing the certainty of the evidence.
Results: We identified no low risk of bias trials. For magnesium supplementation, we included three trials (n = 235); the relative risk (RR) for mortality was 0.54, 95% confidence interval (CI) 0.30-0.96 compared to no supplementation (very low certainty of evidence). For zinc supplementation, two trials were included (n = 168); the RR for mortality was 0.73, 95% CI 0.41-1.28 compared to control. No trials assessed the effects of phosphate supplementation on mortality. For outcomes other than mortality, only zero or one trial was available.
Conclusions: In adult ICU patients, the certainty of evidence for the effects of supplementation with magnesium, phosphate, or zinc was very low. High-quality trials are needed to assess the value of supplementation strategies in these patients.
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| http://dx.doi.org/10.1111/aas.14186 | DOI Listing |
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