Ionized calcium levels in critically ill surgical patients

Area of Science:

• Critical Care Medicine
• Surgical Patient Management
• Clinical Biochemistry

Background:

• Critically ill patients exhibit altered calcium homeostasis.
• Hypocalcemia is a common electrolyte disturbance in critical illness.
• Accurate assessment of ionized calcium is vital for patient outcomes.

Purpose of the Study:

• To investigate ionized calcium levels in critically ill surgical patients.
• To determine the relationship between ionized calcium and mortality.
• To assess the correlation between ionized calcium, total calcium, and albumin.

Main Methods:

• Ionized calcium levels were measured in 74 critically ill surgical patients and 34 healthy controls.
• Total calcium and albumin levels were also assessed.
• Statistical analysis was performed to evaluate correlations and differences.

Main Results:

• Ionized calcium levels were significantly lower in critically ill patients (1.97 mEq/l) compared to controls (2.26 mEq/l).
• A decreased ionized calcium level correlated with increased mortality; no survival was observed below 1.40 mEq/l.
• Albumin levels were reduced in patients, but no correlation was found between ionized calcium and albumin.

Conclusions:

• Critically ill surgical patients frequently present with hypocalcemia.
• Ionized calcium levels are a significant predictor of mortality in this population.
• Direct measurement of ionized calcium is essential, as it may be low irrespective of total calcium or albumin levels.