As outlined in our introduction, hypomagnesemia and, to a lesser degree,
Hypophosphatemia are associated with various forms of cardiac arrhythmia. The
Presence of hypokalemia increases the risk of developing arrhythmias.
Cerebral injury in itself is associated with myocardial damage and
Electrocardiogram abnormalities, including T-wave changes, a shortened P-R
Interval, a prolonged Q-T interval, premature ventricular contractions,
Ventricular ectopy, sinus bradycardia, and ventricular and supraventricular
. Development of electrolyte disorders as reported in the present study may
Increase the risk and severity of these complications after brain injury.
Alternatively, development of these electrolyte deficiencies may be one of the
Mechanisms through which neurologic trauma is associated with arrhythmias.
Various factors combine to put patients in the ICU at risk for the
Development of hypomagnesemia and hypophosphatemia. Causes of hypomagnesemia
Include protein-calorie malnutrition, intravenous administration of Mg-free
Fluids and total parenteral nutrition, as well as diarrhea and steatorrhea,
Short bowel syndrome, bowel fistula, and continuous nasogastric suctioning.
Renal causes include Bartter and Gitelman
Syndromes, postobstructive diuresis, postacute tubular necrosis, renal
Transplantation, and interstitial nephropathy. Medications that can induce renal
Mg wasting include loop and thiazide diuretics, aminoglycosides, amphotericin B,