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Published on: November 9, 2016
Parenteral calcium for intensive care unit patients
Raquel M Forsythe1, Charles B Wessel, Timothy R Billiar
1Surgery, University of Pittsburgh, F-1266.1, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
The Cochrane Database of Systematic Reviews
|October 10, 2008
Summary
Parenteral calcium administration for critically ill patients in intensive care units (ICUs) lacks clear evidence of benefit. This systematic review found no studies linking calcium supplementation to improved outcomes like mortality or reduced organ dysfunction.
Area of Science:
- Critical Care Medicine
- Clinical Pharmacology
- Evidence-Based Medicine
Background:
- Hypocalcemia is common in critically ill patients, with observational studies suggesting a link to mortality.
- Current guidelines often recommend parenteral calcium to correct low serum calcium levels.
- However, the evidence supporting this practice, especially regarding causality and potential harm, is debated.
Purpose of the Study:
- To systematically review the effects of parenteral calcium administration in intensive care unit (ICU) patients.
- To assess impacts on mortality, organ dysfunction, length of stay, costs, and complications.
- To evaluate changes in serum ionized calcium concentration.
Main Methods:
- Comprehensive literature search across multiple databases (Cochrane, MEDLINE, EMBASE) and conference abstracts.
- Inclusion of randomized controlled trials and controlled clinical trials comparing parenteral calcium with placebo or no treatment.
- Independent data extraction and eligibility assessment by two reviewers.
Main Results:
- No studies were identified that evaluated the impact of parenteral calcium supplementation on mortality, organ dysfunction, length of stay, costs, or complications in critically ill ICU patients.
- Five studies (159 participants) reported serum ionized calcium concentrations, showing a small but significant increase post-administration.
- Significant heterogeneity existed across studies regarding patient populations, indications for calcium use, and measurement timing, precluding pooled analysis.
Conclusions:
- There is currently no clear evidence to support the routine use of parenteral calcium supplementation for improving outcomes in critically ill ICU patients.
- Further high-quality research is needed to clarify the role and safety of calcium administration in this population.
- The practice of calcium supplementation for hypocalcemia in the ICU requires re-evaluation based on current evidence limitations.
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