Clarington

Researchers are studying magnesium supplementation in critically ill patients, such as those with severe infections, heart attacks, or respiratory failure. This trial compares two magnesium replacement protocols with different target magnesium levels to see which leads to better survival and fewer cases of atrial fibrillation within 30 days. The study is a multi-center, randomized controlled trial embedded within the electronic medical record systems of hospitals in Ontario, Canada. Participants receive magnesium supplementation according to a protocol targeting either a higher magnesium level >0.95 mmolL or a lower level >0.7 mmolL. Treatment involves intravenous magnesium sulfate doses adjusted based on magnesium levels, with additional oral magnesium options available for the higher target group. Magnesium levels are monitored regularly during ICU stay, and physicians are alerted when magnesium levels fall below critical thresholds. Participants do not need to complete extra tasks or surveys beyond standard ICU care. Researchers will assess outcomes including 30-day survival, days free of atrial fibrillation, organ support use, ventilation, renal therapy, and hospital length of stay. Data collection and outcome monitoring occur through electronic medical records, allowing seamless integration into routine care. The study may continue to track hospital mortality up to 90 days after enrollment.