Physiology of magnesium metabolism and the use of magnesium in intensive care (literature review with the results of own observations, part 1)
The first part of the review presents data on the content of magnesium in organs and tissues of the human body, the role of magnesium in the implementation of multiple functions, and the peculiarities of its intake and excretion from the body. A significant part of the review is devoted to methods for determining the concentration of magnesium in biological fluids of the human body. The advantages, disadvantages and limitations of various methods are presented. The most common methods for studying the concentration of magnesium in biological fluids of the body, which are used in clinical medicine all over the world, are photometric methods with dyes. The role of the fraction of ionized magnesium in the body, the content of which is determined electrochemically, is still uncertain. Cellular magnesium studies are extremely complex and time-consuming. Cells of different organs and tissues normally contain very different amounts of magnesium. It is not possible to judge about the presence of magnesium deficiency in the body by its concentration in plasma or serum. To detect a decrease in the tissue content of magnesium, tests with magnesium load and the subsequent observation of the rate of its excretion from the body are used. The causes for the development of hypomagnesemia are extremely numerous. The main of them are: any severe stress, restriction of magnesium intake into the body, an increase in its losses through the gastrointestinal tract and the kidneys in various pathological conditions. The formation of hypomagnesemia is facilitated by therapy with numerous medications, which are very widely used in clinical practice, and especially in the intensive care. Studies on the distribution of magnesium in the body after its intravenous administration have shown that, despite the large size of hydrated magnesium ions, they can not only paradoxically quickly spread in the extracellular water space, but most likely are also able to quickly penetrate through cell membranes, spreading in the intracellular water compartment.