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Pediatric ionized calcium reference intervals from archived radiometer data.

Catherine L Omosule1, Vincent Holmes2, Cayden Jasek1

  • 1Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, United States.

Clinical Biochemistry
|March 15, 2022
PubMed
Summary
This summary is machine-generated.

Establishing pediatric reference intervals for ionized calcium (iCa) is crucial. This study developed age-specific iCa ranges for children using archived data, revealing greater variability than in adults.

Keywords:
Ionized calciumPediatricRadiometerReference range

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Area of Science:

  • Pediatric clinical chemistry
  • Biomarker reference intervals
  • Calcium homeostasis

Background:

  • Ionized calcium (iCa) is a vital measure of bioavailable calcium, particularly in pediatric care.
  • Established pediatric iCa reference intervals (RI) are lacking, hindering accurate clinical interpretation.
  • This study aimed to establish robust pediatric iCa RI using retrospective data.

Purpose of the Study:

  • To retrospectively calculate age-specific reference intervals (RI) for ionized calcium (iCa) in a pediatric population.
  • To utilize archived data from Radiometer instruments and apply stringent exclusion criteria for data integrity.
  • To compare the developed RI with existing in-house ranges to validate the methodology.

Main Methods:

  • Retrospective analysis of archived data from four Radiometer ABL800 FLEX blood gas analyzers.
  • Application of exclusion criteria based on instrument data to ensure sample quality.
  • Nonparametric rank order calculation of age-specific RI from over 5,000 pediatric individuals.
  • Visual identification of inflection points and outlier removal for robust interval determination.

Main Results:

  • Six age-specific iCa partitions were established for individuals aged 0 to 19 years.
  • Pediatric iCa ranges were wider in early life, narrowing with age to approach adult levels by 2.5 years.
  • Exclusion criteria effectively minimized the inclusion of results from acutely ill children, as suggested by sodium and creatinine data.

Conclusions:

  • Pediatric ionized calcium concentrations exhibit greater variability than adult levels, influenced by developmental and nutritional factors.
  • The study validates the feasibility and cost-effectiveness of using archived Radiometer analyzer data for establishing pediatric RI.
  • This retrospective approach offers a practical alternative for RI development when prospective studies are unfeasible.