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Hypocalcemia in critically ill children.

N Cardenas-Rivero1, B Chernow, M A Stoiko

  • 1Department of Pediatrics, Harvard Medical School, Boston, MA.

The Journal of Pediatrics
|June 1, 1989
PubMed
Summary
This summary is machine-generated.

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Ionized hypocalcemia is common in critically ill children, affecting at least 17.9% of patients. While associated with higher mortality, this may be linked to illness severity rather than calcium levels alone.

Area of Science:

  • Pediatric Intensive Care
  • Critical Care Medicine
  • Endocrinology

Background:

  • Hypocalcemia is a potential complication in critically ill children.
  • Understanding calcium homeostasis is crucial for managing severe pediatric illness.

Purpose of the Study:

  • To determine the prevalence of ionized hypocalcemia in pediatric intensive care unit (PICU) patients.
  • To investigate the clinical consequences and potential causes of hypocalcemia in this population.

Main Methods:

  • Prospective study of calcium homeostasis in 145 PICU patients.
  • Measurement of total serum calcium and ionized calcium levels.
  • Assessment of illness severity using the Therapeutic Intervention Scoring System (TISS) and evaluation for sepsis and hypoparathyroidism.

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Main Results:

  • The prevalence of ionized hypocalcemia was at least 17.9%.
  • Patients with ionized hypocalcemia had a significantly higher mortality rate (31% vs 2.5%).
  • Ionized hypocalcemia was associated with greater illness severity, sepsis, and vasopressor use.

Conclusions:

  • Ionized hypocalcemia is prevalent in severely ill children.
  • While associated with increased mortality, causality is confounded by illness severity.
  • Functional hypoparathyroidism may contribute to hypocalcemia in critically ill children.