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Hypercalcemia associated with extracorporeal life support in neonates
J H Fridriksson1, M A Helmrath, J J Wessel
1Division of Neonatology,Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.
Journal of Pediatric Surgery
|February 28, 2001
Summary
Hypercalcemia is common in neonates on extracorporeal life support (ECLS), affecting 36%. This condition is linked to longer ECLS duration and increased platelet transfusions, suggesting cautious calcium administration.
Area of Science:
- Neonatal intensive care
- Pediatric critical care
- Cardiopulmonary support
Background:
- Calcium homeostasis disturbances are frequent during extracorporeal life support (ECLS).
- Hypercalcemia has been observed in neonates requiring ECLS at the authors' institution.
Purpose of the Study:
- To determine the incidence of hypercalcemia in neonates undergoing ECLS.
- To identify factors associated with hypercalcemia in this population.
Main Methods:
- Retrospective chart review of 76 neonates who underwent ECLS before 10 days of age.
- Data collected included demographics, clinical information, and laboratory values before and during ECLS.
- Hypercalcemia defined as serum calcium > 11 mg/dL after the first 24 hours of ECLS.
Main Results:
- Hypercalcemia was identified in 36% (25/70) of neonates on ECLS.
- Hypercalcemia was associated with significantly longer ECLS duration (243 vs. 139 hours) and higher platelet transfusion requirements (538 vs. 372 mL).
- No explanation for hypercalcemia was found based on primary diagnosis, calcium administration, or acid-base status.
Conclusions:
- Hypercalcemia is a common complication in neonates requiring ECLS.
- The presence of hypercalcemia correlates with prolonged ECLS support and increased transfusion needs.
- Conservative calcium administration strategies may be beneficial for neonates on ECLS.