Authors: M. Balík 1; F. Duška 2; V. Černý 2-7; V. Šrámek 8; M. Matějovič 9; D. Springer 10; H. Lahoda Brodská 10 Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzívní medicíny VFN a 1. LF UK, Praha 1; Klinika anesteziologie a resuscitace, Fakultní nemocnice Královské Vinohrady, Univerzita Karlova v Praze, 3. LFUK, Praha 2; Klinika anesteziologie, perioperační a intenzivní medicíny, Masarykova nemocnice v Ústí nad Labem, Univerzita J. E. Purkyně v Ústí nad Labem 3; Národní institut kvality a excelence zdravotnictví, Praha 4; Univerzita Karlova v Praze, Lékařská fakulta v Hradci Králové, Klinika anesteziologie, resuscitace a intenzivní medicíny 5; Dept. of Anesthesia, Pain Management and and Perioperative Medicine, Dalhousie University, Halifax, Canada 6; Ústav klinických oborů a biomedicíny, Technická univerzita Liberec 7; Klinika anesteziologie, resuscitace a intenzívní medicíny, Fakultní nemocnice U Sv. Anny, Masarykova Univerzita, Brno 8; I. interní klinika, LF v Plzni, Univerzita Karlova a Fakultní nemocnice Plzeň 9; Ústav lékařské biochemie a laboratorní diagnostiky VFN a 1. LFUK, Praha 10 Published in: Klin. Biochem. Metab., 34, 2026, No. 1, p. 30-33 doi: https://doi.org/10.61568/kbm.2026.006
Ionised magnesium (Mg2+) represents biologically active form of total plasmatic magnesium and an essential electrolyte with an impact on cellular functions, metabolism, creation of energy substrates (ATP), myocardial electrical stability and the neuromuscular transmission. Critically ill patients face significant changes in acid-base regulation, distribution of body fluids and hormonal regulations, which render traditional estimates of total magnesium levels insufficiently informative and potentially misleading. This collaborative intersocietal position statement summarizes current state-of-the-art scientific and clinical experiences, resulting in recommendations for introduction of a routine Mg2+ measurement in the critical care practice. An availability of Mg2+ measurement in selected groups of patients is desirable in relation to new methods in the intensive care practice and is considerably supported by the known deficit of magnesium in the general population. The Mg2+ estimates are suitable for the intensive care units and the critically ill in Czechia. The prominent indications are especially regional citrate anticoagulation and renal failure, in patients with heart failure and a risk of arrhythmias including perioperative arrhythmias at the complex cardiovascular centres. Furthermore, the measurements are recommended in diabetic and septic patients. Mg2+ should be taken everywhere in shock accompanied with significant shifts in body fluids and acid-base regulation associating with a positive balance of fluids followed by a de-resuscitation phase and a subsequent fluid elimination. The measurement should be available 24/7 as part of the point-of-care analysis similarly as the level of ionised calcium (Ca2+).
intensive care – magnesium – heart failure – arrhythmias – ionised magnesium – regional citrate anticoagulation
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