Study of Ionized Magnesium and Calcium Levels in a Cohort of Patients with Septic Shock Treated with Standard Therapy and Antioxidants

Background: Septic shock is the most serious form of sepsis and can be due to several factors, such as hypovolemia, vascular hyporesponsiveness, myocardial dysfunction, or dysfunction of the circulation. Likewise, electrolyte levels have been associated with septic shock in intensive care units, although it has been underdiagnosed. Based on this, the purpose of the present work was to evaluate plasma ionic levels in patients with septic shock before and after treatment with different antioxidants. Methods: Plasma ionic levels were measured (Na+, K+, Cl- and ionized Ca2+ and Mg2+) in 194 subjects, 129 healthy control patients, 14 patients with septic shock without treatment and 51 patients with septic shock under treatment with 4 different antioxidants (N-acetyl cysteine, melatonin, vitamin C and vitamin E). Results: We found important differences when comparing the plasma ionic levels of K+, Ca2+ and Mg2+ between the control group versus in both groups with sepsis at the time of hospital admission. In patients with septic shock, there is a decrease in the serum levels of ionized Na+, K+, Cl- and Ca2+ and Mg2+. Antioxidant treatment as an adjunct to the standard management of patients with septic shock increases the electrolyte deficit. The correction of the magnesium deficit also leads to an increase in serum calcium and potassium levels. Conclusion: The management of antioxidant therapy in patients with septic shock within the first hours of admission can help to improve their ionic levels of Ca2+ and Mg2+, mainly in patients with lung damage.Clinical Trial gov registration: NCT03557229. Registered june 14, 2018. https://clinicaltrials.gov/ct2/show/NTC03557229?term=aISA+ALFREDO&draw=2&rank=1