Recruiting

Magnesium Protocols

Sponsor:

Scarborough General Hospital

Code:

NCT07173855

Conditions

Critical Illness

Eligibility Criteria

Sex: All

Age: 16+

Healthy Volunteers: Not accepted

Interventions

Magnesium sulfate administration

Magnesium oxide

Magnesium glucoheptonate

Study Details

Brief 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.

Conditions

Critical Illness

Study ID

NCT07173855

Start date

Nov 25, 2025

Status verified date

Sep, 2025

Completion date

Jun 1, 2027

Anticipated

Primary completion date

Mar 1, 2027

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 16+

Healthy Volunteers: Not accepted

Inclusion Criteria:

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

Exclusion Criteria:

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

Study Design

Enrollment

3253 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

other: Lower target (>0.7mmol)

Protocolized magnesium replacement according to magnesium level as follows: for 0.45 - 0.70mmol/L, magnesium sulfate 4g IV x 1 and repeat magnesium level the next day; for < 0.45mmol/L, magnesium sulfate 6g IV x 1, alert most responsible physician, and repeat level in 4 hours.

other: Higher target (>0.95mmol/L)

Protocolized magnesium replacement according to magnesium level as follows: for 0.75-0.95mmol/L, magnesium sulfate 2g IV x 1, magnesium oxide 420 mg po q12h x 2, or magnesium glucoheptonate 30mL po q12h x 2; for 0.45 - 0.74mmol/L, magnesium sulfate 4g IV x 1 and repeat magnesium level the next day; for < 0.45mmol/L, magnesium sulfate 6g IV x 1, alert most responsible physician, and repeat level in 4 hours.

Interventions

Magnesium sulfate administration

Magnesium sulfate is used in both arms for magnesium replacement.

Magnesium 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.

Magnesium glucoheptonate

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

Primary outcome measure

  • 30-day ordinal composite of hospital mortality and days free of atrial fibrillation in ICU [ Time Frame: 30 days after enrollment. ]

Central Contacts and Locations

Central contacts

Joshua Craig

4164382911jcraig@shn.ca

Locations

Lakeridge Health Ajax-Pickering

Recruiting

Ajax, Ontario, Canada, L1S 2J4

Contacts

Sarah Dulmage

9055768711sdulmage@lh.ca

Lakeridge Health Bowmanville

Recruiting

Bowmanville, Ontario, Canada, L1C 2N3

Contacts

Sarah Dulmage

905-576-8711sdulmage@lh.ca

Lakeridge Health Oshawa

Recruiting

Oshawa, Ontario, Canada, L1G 8A2

Contacts

Sarah Dulmage

905-576-8711sdulmage@lh.ca

Scarborough Centenary Hospital

Recruiting

Toronto, Ontario, Canada, M1E 4B9

Contacts

Joshua Craig

4164382911jcraig@shn.ca

Scarborough General Hospital

Recruiting

Toronto, Ontario, Canada, M1P2V5

Contacts

Joshua Craig

4164382911jcraig@shn.ca

Scarborough Birchmount Hospital

Recruiting

Toronto, Ontario, Canada, M1W 3W3

Contacts

Joshua Craig

4164382911jcraig@shn.ca

More Information

Sponsor

Scarborough General Hospital

Last update posted

Apr 27, 2026

Last verified

Sep, 2025

Keywords

  • Critical illness
  • Magnesium
  • Atrial fibrillation
  • Protocols

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by Scarborough General Hospital on 2026-04-27.