Hypocalcemia in critically ill patients

Area of Science:

• Critical care medicine
• Calcium metabolism
• Electrolyte balance

Background:

• Calcium regulation is crucial for physiological functions.
• Altered calcium levels are frequently observed in critically ill patients.
• Understanding calcium metabolism is vital for managing critical illness.

Purpose of the Study:

• To review calcium regulation in critical illness.
• To discuss causes, clinical features, and treatment of hypocalcemia.
• To examine hemodynamic effects and interactions of calcium administration.

Main Methods:

• Review of representative medical literature.
• Inclusion of animal and human investigations.
• Discussion of in vitro and in vivo studies.

Main Results:

• Ionized hypocalcemia is common in critical illness, often due to parathyroid hormone or vitamin D dysfunction, or calcium chelation.
• Clinical manifestations include cardiovascular and neuromuscular insufficiency.
• Intravenous calcium is effective for moderate-to-severe hypocalcemia, but can impair beta-adrenergic agonist actions and may be harmful during ischemia.

Conclusions:

• Calcium regulation is frequently altered in critical illness.
• Effective management of hypocalcemia requires understanding its underlying pathophysiology.
• Optimal treatment strategies are essential for critically ill patients with calcium imbalances.