Profound ionized hypomagnesemia induced by therapeutic plasma exchange in liver failure patients.
BACKGROUND
Various adverse effects, including cardiac arrest, have been induced by plasma exchange (PE). Electrolyte derangement is frequently observed. The purpose of this study was to assess the effect of PE on the serum ionized magnesium (Mg2+) concentration in acute liver failure patients.


METHODS
Seven liver failure patients requiring PE were enrolled in this study. PE was performed 21 times in total. Blood samples were drawn before PE and serially after the start of the PE. Serum Mg2+ was measured by the ion- selective electrode method.


RESULTS
After PE was started, Mg2+ concentrations began to fall significantly. The low Mg2+ blood concentration continued during PE. After PE, the Mg2+ level recovered to about 80 percent of the control value within 2 hours in six patients. However, in one patient, the Mg2+ concentration was still low even at 2 hours after PE. This patient complained of chest discomfort during PE and ECG analysis showed sporadic supraventricular premature contractions.


CONCLUSIONS
Profound ionized hypomagnesemia was induced by PE in liver failure patients.
Kamochi
Masayuki
M
Intensive and Critical Care Unit, Blood Transfusion Unit, University Hospital of Occupational and Environmental Health, Kitakyushu City, Fukuoka, Japan. kamochi@clnc.uoeh-u.ac.jp
Aibara
Keiji
K
Nakata
Koichi
K
Murakami
Masahiro
M
Nandate
Koichiro
K
Sakamoto
Hisahiro
H
Sata
Takeyoshi
T
Shigematsu
Akio
A
D000136:Acid-Base Equilibrium; D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood; D005260:Female; D006400:Hematocrit; D006801:Humans; D017736:Ion-Selective Electrodes; D017093:Liver Failure / Q000150:complications* / Q000628:therapy; D008274:Magnesium / Q000097:blood*; D008275:Magnesium Deficiency / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange / Q000009:adverse effects*; D013997:Time Factors; D014883:Water-Electrolyte Imbalance / Q000209:etiology
D008274:Magnesium; D002118:Calcium