{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T12:42:43Z","timestamp":1794573763401,"version":"4.9.1"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Enteral magnesium replacement may be as effective as IV replacement while being a cheaper and more environmentally sustainable intervention. The primary objective was to evaluate whether enteral magnesium is noninferior to IV administration in correcting hypomagnesemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Prospective, open-label, parallel-group, electronic medical record-embedded, randomized, noninferiority trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Single-center mixed medical-surgical-trauma ICU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>Patients with serum magnesium concentration between 0.35 and 0.7 mmol\/L.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions:<\/jats:title>\n                    <jats:p>Enteral or IV magnesium replacement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results:<\/jats:title>\n                    <jats:p>\n                      The primary outcome was serum magnesium concentration at 24 hours after enrollment, with a noninferiority margin of 0.1 mmol\/L. Secondary outcomes included dose of administered magnesium, urine magnesium excretion, costs of intervention delivery, waste, bloodstream infections, new atrial fibrillation, duration of admission, and mortality. Between June 2023 and May 2024, 360 patients were included. Baseline magnesium concentrations were comparable. At 24 hours, mean (\n                      <jats:sc>sd<\/jats:sc>\n                      ) magnesium concentrations were 0.80 mmol\/L (0.19 mmol\/L) in the enteral arm and 0.92 mmol\/L (0.23 mmol\/L) in the IV arm, with a mean difference of \u20130.12 mmol\/L (95% CI, \u20130.16 to \u20130.07 mmol\/L) indicating inconclusive results about noninferiority. Enteral replacement substantially decreased urine magnesium concentrations compared with IV replacement (median difference of area under the curve, \u201346.2 mmol\u00b7hr\/L), cost (median difference, \u20136.48 Australian dollars; 95% CI, \u20137.40 to \u20135.56 Australian dollars), waste (median difference, \u201355 grams; 95% CI, \u201358 to \u201351 grams), C\n                      <jats:sc>o<\/jats:sc>\n                      <jats:sub>2<\/jats:sub>\n                      footprint (median difference, \u2013946 grams; 95% CI, \u2013996 to \u2013896 grams), and additional IV fluid administration (median, \u2013100\u2009mL; interquartile range, \u2013200 to \u2013100\u2009mL). There were no between group differences for other outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Enteral magnesium replacement for mild-to-moderate hypomagnesemia did not establish noninferiority to IV replacement at a margin of 0.1 mmol\/L but it reduced urinary concentration of magnesium, cost, environmental waste, carbon emissions, and IV fluid administration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/ccm.0000000000007174","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T14:00:29Z","timestamp":1780322429000},"page":"1954-1964","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Enteral When Compared With IV Magnesium Replacement in the Critically Ill: A Noninferiority Randomized Clinical Trial"],"prefix":"10.1097","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3112-1361","authenticated-orcid":false,"given":"Chinh D.","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia."},{"name":"Intensive Care Unit, Royal Melbourne Hospital, Melbourne, VIC, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haustine P.","family":"Panganiban","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia."},{"name":"Intensive Care Unit, Royal Melbourne Hospital, Melbourne, VIC, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalia","family":"Karahalios","sequence":"additional","affiliation":[{"name":"Center for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia."},{"name":"Methods and Implementation Support for Clinical and Health research (MISCH) Hub, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Fazio","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia."},{"name":"Department of Medicine, Royal Melbourne Hospital, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia."},{"name":"Clinical Informatics Centre, Royal Melbourne Hospital, Melbourne, VIC, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa J.","family":"Ankravs","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia."},{"name":"Intensive Care Unit, Royal 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Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"McAlister","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia."},{"name":"Healthcare Carbon Lab, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"An","family":"Tran-Duy","sequence":"additional","affiliation":[{"name":"Methods and Implementation Support for Clinical and Health research (MISCH) Hub, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia."},{"name":"Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher 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