In August 1993, I was asked to review the events surrounding the intravenous administration of 224 mmol of magnesium sulfate over a 7-hour period to a 74-year-old hospital patient with asymptomatic hypomagnesemia. The ensuing respiratory arrest was accompanied by asystole soon thereafter. There was gratifying response to intubation, ventilation, external cardiac compression, administration of epinephrine and atropine, and discontinuance of the magnesium infusion. Intravenous saline administration over the subsequent 48-hour period allowed reduction in the serum magnesium concentration from 7.2 to 1.65 mmol/L (normal range, 0.7 to 1.1 mmol/L). The total dose of magnesium and the rate of infusion were very similar to those recently reported as the cause of parasympathetic and neuromuscular blockade, requiring ventilatory assistance in a 27-year-old patient.1
In that May 10, 1993, article, the normal values for serum magnesium are stated incorrectly by factors of 4 to 5 in millimoles per liter (mmol/L) (once) and
Kuiper JJ. Communicating Magnesium Content. Arch Intern Med. 1994;154(8):922–923. doi:10.1001/archinte.1994.00420080132014
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