Paediatric trauma and hypocalcaemia: a systematic review.

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.