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Paediatric trauma and hypocalcaemia: a systematic review.

Mary-Beth Toner1, Michael Coffey2, Ulugbek Nurmatov3

  • 1Royal Belfast Hospital for Sick Children, Belfast, UK mtoner13@qub.ac.uk.

Archives of Disease in Childhood
|December 12, 2024
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Summary

Hypocalcaemia (low calcium) in paediatric trauma is less common than in adults. Limited studies suggest it may be linked to worse outcomes, but more research is needed to confirm these findings in children.

Keywords:
Intensive Care Units, PaediatricPaediatric Emergency MedicineResuscitation

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Area of Science:

  • Pediatric Emergency Medicine
  • Trauma Surgery
  • Critical Care

Background:

  • Trauma is a major cause of child mortality and morbidity globally.
  • Hypocalcaemia is linked to adverse outcomes in adult trauma but is understudied in children.
  • This review examines hypocalcaemia in paediatric trauma patients.

Purpose of the Study:

  • To systematically review the prevalence of hypocalcaemia in paediatric trauma.
  • To investigate the clinical implications and associations of hypocalcaemia in this population.
  • To identify gaps in current research for future studies.

Main Methods:

  • Comprehensive literature search of four databases and grey literature.
  • Inclusion of original studies on paediatric trauma with pre-transfusion ionized calcium measurements.
  • Exclusion of case reports, series, reviews, and non-English papers; quality assessment using Newcastle-Ottawa Scale.

Main Results:

  • Two retrospective cohort studies involving 568 patients met inclusion criteria.
  • Hypocalcaemia incidence ranged from 5.3% to 19.8%.
  • Observed trends towards increased mortality, transfusion needs, and hospital stay, but without consistent statistical significance.

Conclusions:

  • Hypocalcaemia incidence in paediatric trauma is lower than in adults.
  • Limited evidence suggests potential adverse outcome associations, though not consistently significant.
  • Further prospective research with larger sample sizes is crucial for definitive understanding and improved patient management.