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medRxiv PreprintsInternational4 November 2026

Effect of protocolized MAGNesium replacement in critically ill patients On mortaLIty and Atrial fibrillation: protocol for the MAGNOLIA randomized controlled trial

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Background: Measurement of serum magnesium levels, and administration of supplemental magnesium when levels are below target, is a common element of routine care for critically ill patients. However, targets for replacement vary, and the targets that lead to the best outcomes are unknown. Methods: Multi-center open-label parallel group randomized controlled superiority trial of adult critically ill patients receiving protocolized magnesium replacement, comparing a higher target (>0.95mmol/L) to a lower target (>0.7mmol/L). The trial will be embedded into the electronic health record (EHR) at 6
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