Effects of magnesium, phosphate and zinc supplementation in ICU patients-Protocol for a systematic review.


Journal

Acta anaesthesiologica Scandinavica
ISSN: 1399-6576
Titre abrégé: Acta Anaesthesiol Scand
Pays: England
ID NLM: 0370270

Informations de publication

Date de publication:
01 2020
Historique:
received: 23 08 2019
accepted: 03 09 2019
pubmed: 12 9 2019
medline: 12 1 2021
entrez: 12 9 2019
Statut: ppublish

Résumé

Depletion of the trace elements magnesium, phosphate and zinc is common in patients admitted to the intensive care unit (ICU). Observational studies have suggested worse outcome in patients with hypomagnesaemia, hypophosphataemia or hypozincaemia, but also inverse associations with worse outcome with too high serum levels. However, it is unclear whether data from randomised clinical trials (RCTs) confirm this. Accordingly, we plan to assess the balance between benefits and harms of supplementation as compared with placebo or no supplementation in adult ICU patients. We will conduct a systematic review of RCTs with meta-analysis and trial sequential analysis in accordance with the Cochrane Handbook for Systematic Reviews of Interventions, the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement and the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach. We will assess the effects of any supplementation with magnesium, phosphate or zinc vs. placebo or no treatment in adult ICU patients. We will systematically search the Cochrane CENTRAL, Embase, PubMed, and for unpublished trials: ClinicalTrials.gov, the EU clinical Trials Register and the WHO International Clinical Trials Registry Platform. The primary outcomes will be days alive without mechanical ventilation and overall mortality. Secondary outcomes include use for mechanical ventilation, tachy-arrhythmias, use of vasopressors, length of hospital stay and use of renal replacement therapy. The benefits and harms of supplementation therapy with magnesium, phosphate and zinc in general ICU patients are unknown. This outlined systematic review will provide data on the evidence, on which future recommendations for supplementation may be founded.

Sections du résumé

BACKGROUND
Depletion of the trace elements magnesium, phosphate and zinc is common in patients admitted to the intensive care unit (ICU). Observational studies have suggested worse outcome in patients with hypomagnesaemia, hypophosphataemia or hypozincaemia, but also inverse associations with worse outcome with too high serum levels. However, it is unclear whether data from randomised clinical trials (RCTs) confirm this. Accordingly, we plan to assess the balance between benefits and harms of supplementation as compared with placebo or no supplementation in adult ICU patients.
METHODS
We will conduct a systematic review of RCTs with meta-analysis and trial sequential analysis in accordance with the Cochrane Handbook for Systematic Reviews of Interventions, the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement and the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach. We will assess the effects of any supplementation with magnesium, phosphate or zinc vs. placebo or no treatment in adult ICU patients. We will systematically search the Cochrane CENTRAL, Embase, PubMed, and for unpublished trials: ClinicalTrials.gov, the EU clinical Trials Register and the WHO International Clinical Trials Registry Platform. The primary outcomes will be days alive without mechanical ventilation and overall mortality. Secondary outcomes include use for mechanical ventilation, tachy-arrhythmias, use of vasopressors, length of hospital stay and use of renal replacement therapy.
DISCUSSION
The benefits and harms of supplementation therapy with magnesium, phosphate and zinc in general ICU patients are unknown. This outlined systematic review will provide data on the evidence, on which future recommendations for supplementation may be founded.

Identifiants

pubmed: 31506930
doi: 10.1111/aas.13468
doi:

Substances chimiques

Phosphates 0
Magnesium I38ZP9992A
Zinc J41CSQ7QDS

Types de publication

Journal Article Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

131-136

Subventions

Organisme : Research foundation of Rigshospitalet, Copenhagen University Hospital, Denmark
Pays : International

Informations de copyright

© 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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Auteurs

Gitte Kingo Vesterlund (GK)

Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.

Thordis Thomsen (T)

Herlev Acute, Critical and Emergency Care Science Unit (Herlev-ACES), Herlev and Gentofte University Hospital, Copenhagen, Denmark.

Morten Hylander Møller (MH)

Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Centre for Research in Intensive Care (CRIC), Copenhagen, Denmark.

Anders Perner (A)

Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Centre for Research in Intensive Care (CRIC), Copenhagen, Denmark.

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