This protocol addresses hypermagnesemia in the specific situation where the first-line strategy of promoting kidney excretion of magnesium with an intravenous sodium chloride 0.9% infusion has not achieved the required urine output target.
The preceding step used intravenous sodium chloride 0.9% to reduce serum magnesium by promoting kidney excretion, aiming for a urine output of at least 60 mL per hour. When that urine output target cannot be reached, escalation to this next protocol is indicated.
When adequate urine output cannot be achieved with the sodium chloride infusion alone, an additional intravenous agent is introduced alongside it to further drive kidney excretion of magnesium. The complete regimen is available in the structured protocol below.
If this urine output can't be achieved, intravenous frusemide can be added.
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