Hypomagnesemia in newborns with hypoxic ischemic encephalopathy and whole-body hypothermia

Abstract

In newborns with the diagnosis of hypoxic-ischemic encephalopathy (HIE) treated with hypothermia, metabolic alterations are observed, which are associated with neurological prognosis. Hypomagnesemia has been reported frequently in the literature in these patients, but it is not measured or corrected in all neonatal healthcare centers.

Objective: To evaluate the frequency of hypomagnesemia and hypocalcemia in newborns with HIE treated with whole-body hypothermia and to evaluate the response to the magnesium sulfate administration.

Patients and Method: Prospective, observational and descriptive study in hospitalized newborns with the diagnosis of HIE and treated with whole-body hypothermia between the years 2016 and 2017. Serial blood measurement of magnesemia (Mg) and calcemia (Ca) was performed. When presenting an Mg level ≤ 1.8 mg/dl, supplementation with magnesium sulfate was administered to maintain levels between 1.9 and 2.8 mg/dl. The frecuency of hypomagnesemia, hypocalcemia and clinical evolution was registered. A descriptive statistical analysis was performed, with central tendency measures.

Results: Sixteen cases were included, 13 of them presented hypomagnesemia (81.3%), with early-onset (6-36 hours of life), which was normalized with magnesium sulfate treatment, receiving a second dose 4 patients. Six of 16 patients presented hypocalcemia (37.5 %).

Conclusions: Hypomagnesemia is frequent (80%), similar to that described in the literature, and should be controlled and corrected early, given its physiological role, in the same way that calcium is controlled.