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Critical care hypercalcemia--a hyperparathyroid state.

L Lind1, S Ljunghall

  • 1Department of Anaesthesiology, Gävle County Hospital, Sweden.

Experimental and Clinical Endocrinology
|January 1, 1992
PubMed
Summary
This summary is machine-generated.

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Critical care hypercalcemia affects 32% of ICU patients, often with acute renal failure. Illness severity, not just renal issues, predicts its occurrence, suggesting parathyroid overactivity.

Area of Science:

  • Critical Care Medicine
  • Nephrology
  • Endocrinology

Background:

  • Hypocalcemia is common in critically ill patients, with occasional hypercalcemia reported.
  • Understanding critical care hypercalcemia is crucial for patient management.

Purpose of the Study:

  • To determine the incidence and characteristics of hypercalcemia in intensive care unit (ICU) patients.
  • To investigate the relationship between hypercalcemia, acute renal failure (ARF), and illness severity.

Main Methods:

  • Serum calcium levels were measured in 83 critically ill ICU patients (TISS score ≥ 40).
  • Severity of illness was assessed using APACHE-II and multiple organ failure scores.
  • Parathyroid hormone (PTH) levels were measured in a subset of patients.

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Main Results:

  • 32% of patients developed hypercalcemia (serum calcium ≥ 2.60 mmol/l).
  • Hypercalcemia was more frequent and occurred earlier in patients with ARF.
  • Illness severity, indicated by failing organ systems, was the strongest predictor of hypercalcemia.
  • Elevated PTH levels in hypercalcemic patients without ARF suggested parathyroid overactivity.

Conclusions:

  • Critical care hypercalcemia is common, mild, and frequently associated with renal failure.
  • The severity of critical illness is the primary predictor of hypercalcemia.
  • Elevated PTH levels suggest parathyroid overactivity as a cause of ICU hypercalcemia.