RecruitingPhase 4NCT07173855

Effect of Protocolized Magnesium Replacement on Mortality and Atrial Fibrillation in Critically Ill Patients

Effect of Protocolized Magnesium Replacement in Critically Ill Patients on Mortality and Atrial Fibrillation: the MAGNOLIA Randomized Controlled Trial


Sponsor

Scarborough General Hospital

Enrollment

3,253 participants

Start Date

Nov 25, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

In patients with critical illness, such as severe infections, heart attacks, or respiratory failure, most intensive care units (ICUs) measure magnesium levels and give supplemental doses of magnesium when levels are below certain targets. However, the best targets are unknown. The goal of this clinical trial is to study protocols for magnesium supplementation in people with critical illness, comparing a protocol with higher target level to a protocol with a lower target level. The main question this study aims to answer is whether magnesium supplementation protocols targeting a higher or lower level lead to better 30-day survival and less atrial fibrillation. Participants will not have to do any specific tasks, undergo any additional tests, or complete any surveys.


Eligibility

Min Age: 16 Years

Inclusion Criteria3

  • Age 16 years or older
  • Admission orders written to a medical-surgical intensive care unit at a participating site
  • Magnesium replacement protocol ordered

Exclusion Criteria4

  • Prior enrollment in or withdrawal from MAGNOLIA trial
  • Sustained ventricular tachycardia
  • Pre-eclampsia
  • Myasthenia gravis

Interventions

DRUGMagnesium sulfate administration

Magnesium sulfate is used in both arms for magnesium replacement.

DRUGMagnesium oxide

In the higher-target arm, magnesium oxide 420mg po q12h x 2 is one of the options available for magnesium replacement when magnesium levels lie between 0.75 and 0.95mmol/L.

DRUGMagnesium glucoheptonate

Magnesium glucoheptonate 30mL po q12h x 2 is an oral option for magnesium replacement in the higher-target arm.


Locations(5)

Lakeridge Health Ajax-Pickering

Ajax, Ontario, Canada

Lakeridge Health Oshawa

Oshawa, Ontario, Canada

Scarborough Centenary Hospital

Toronto, Ontario, Canada

Scarborough General Hospital

Toronto, Ontario, Canada

Scarborough Birchmount Hospital

Toronto, Ontario, Canada

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NCT07173855


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