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Hypocalcemia in critically ill patients

B Chernow, G Zaloga, E McFadden

    Critical Care Medicine
    |December 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

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    Hypocalcemia is common in ICU patients, affecting 64% of those with measured calcium. Low calcium levels are linked to longer ICU stays, increased complications like sepsis and renal failure, and higher mortality rates.

    Area of Science:

    • Critical Care Medicine
    • Clinical Biochemistry
    • Internal Medicine

    Background:

    • Hypocalcemia is a frequent metabolic disturbance in critically ill patients.
    • Accurate assessment of calcium status is crucial for patient management.
    • Factors like albumin levels and acid-base balance can affect total serum calcium measurements.

    Purpose of the Study:

    • To determine the frequency of hypocalcemia in intensive care unit (ICU) patients.
    • To identify patient subsets at risk for hypocalcemia.
    • To evaluate the clinical outcomes associated with hypocalcemia in the ICU.

    Main Methods:

    • Retrospective study of 259 ICU admissions.
    • Serum calcium levels measured in 210 patients.
    • Analysis of factors including serum albumin, arterial pH, and ionized calcium levels.

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    Main Results:

    • 64% of patients exhibited hypocalcemia (serum Ca++ < 8.5 mg/dl).
    • Hypocalcemia was associated with hypoalbuminemia and alkalosis.
    • Hypocalcemic patients had longer ICU stays, higher rates of renal failure, sepsis, and increased mortality.
    • Ionized calcium levels were significantly lower in hypocalcemic patients.

    Conclusions:

    • Hypocalcemia is highly prevalent in critically ill patients.
    • Ionized calcium measurement is valuable due to confounding factors like pH and albumin.
    • Hypoalbuminemia, sepsis, blood transfusions, and renal failure are risk factors for hypocalcemia.
    • Hypocalcemia is linked to poorer clinical outcomes in the ICU.