Related Experiment Videos

Ionized hypocalcemia is an early event and is associated with organ dysfunction in children admitted to the intensive

Cacilda Rosa Barbosa Dias1, Heitor Pons Leite, Paulo Cesar Koch Nogueira

  • 1Pediatric Intensive Care Unit, Department of Pediatrics, the Federal University of São Paulo.

Journal of Critical Care
|May 21, 2013
PubMed

Insights

Ionized hypocalcemia is frequent in pediatric intensive care units (ICUs), especially within the first three days. While not a mortality predictor, it indicates more severe organ dysfunction.

Area of Science:

  • Pediatric Critical Care Medicine
  • Pediatric Endocrinology
  • Clinical Chemistry

Background:

  • Ionized hypocalcemia is a common electrolyte disturbance in critically ill children.
  • Understanding its incidence, risk factors, and prognostic implications is crucial for pediatric intensive care unit (ICU) management.

Purpose of the Study:

  • To determine the frequency and risk factors of ionized hypocalcemia in pediatric ICU patients.
  • To evaluate ionized hypocalcemia as a predictor of mortality in this population.

Main Methods:

  • Prospective cohort study of 337 children admitted to the ICU.
  • Serum ionized calcium levels monitored for the first 10 days.
  • Analysis of risk factors including age, malnutrition, sepsis, severity scores (PIM2, PLOD), and medications (steroids, furosemide, anticonvulsants).
  • Hypocalcemia defined as serum ionized calcium < 1.15 mmol/L.

Main Results:

  • The incidence of hypocalcemia was high at 77.15%.
  • Higher Pediatric Logistic Organ Dysfunction (PLOD) scores in the first 3 days were independently associated with hypocalcemia (OR 2.24).
  • Furosemide and methylprednisolone use (at specific doses) were associated with hypocalcemia.
  • No significant association between hypocalcemia and 10-day mortality was found.

Conclusions:

  • Ionized hypocalcemia is a prevalent condition in pediatric ICUs, particularly early in the admission.
  • It is not a predictor of mortality but is linked to increased organ dysfunction severity.
  • Early identification and monitoring of ionized calcium may be important in managing critically ill children.
Abstract

Keywords:
Critical illnessFurosemideHypocalcemiaIntensive care unitMultiple organ failurePediatricSteroids

Related Concept Videos

Skeleton and Calcium Homeostasis01:21

Skeleton and Calcium Homeostasis

Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
Diabetic Ketoacidosis l: Introduction01:25

Diabetic Ketoacidosis l: Introduction

DefinitionDiabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes mellitus, characterized by a triad of hyperglycemia (blood glucose >250 mg/dL), ketonemia or ketonuria, and metabolic acidosis (arterial pH <7.30 and serum bicarbonate <18 mEq/L). It results from insulin deficiency combined with elevated levels of counterregulatory hormones—glucagon, catecholamines, cortisol, and growth hormone—leading to increased lipolysis, hepatic ketone production, and...
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
Diabetic Ketoacidosis ll: Pathophysiology01:22

Diabetic Ketoacidosis ll: Pathophysiology

Diabetic ketoacidosis (DKA) is a metabolic emergency characterized by hyperglycemia, ketonemia, and metabolic acidosis. It results from severe insulin deficiency and an excess of counterregulatory hormones, leading to uncontrolled lipolysis, ketogenesis, and widespread electrolyte and fluid disturbances.Pathophysiology The central event in DKA is a profound loss of insulin action. Without insulin, glucose uptake in insulin-dependent tissues is impaired, while hepatic glucose production...
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...