Effects of magnesium, phosphate, or zinc supplementation in intensive care unit patients—A systematic review and meta‐analysis

医学 荟萃分析 相对风险 随机对照试验 重症监护室 置信区间 临床试验 重症监护医学 内科学 系统回顾 出版偏见 梅德林 政治学 法学
作者
Gitte Kingo Vesterlund,Thomas Steen Jensen,Karen Louise Ellekjær,Morten Hylander Møller,Thordis Thomsen,Anders Perner
出处
期刊:Acta Anaesthesiologica Scandinavica [Wiley]
卷期号:67 (3): 264-276 被引量:7
标识
DOI:10.1111/aas.14186
摘要

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.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.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.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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