Hypocalcemia in children with septic shock

Buysse, Cmp; Kaay, Dcm van der; Voort, Edwin van der; Hoog, Matthijs de; Hazelzet, J A; Joosten, K.F.

doi:10.1186/cc1276

Cited by 2 publications

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“…Mg deficiency was linked to inborn error of metabolism in our study. 16 De Menezes et al reported 76% of the critical children had hypophosphatemia on admission 6 & 60% in a retrospective Turkish study. 19 Meneses et al found that hypophosphatemia was common in the first 10 days of ICU hospitalization and was associated with the diagnosis of respiratory disease, use of dopamine, and malnutrition.…”

Section: Discussionmentioning

confidence: 97%

“…In a study by Buysse CMP et al on 26 children with septic shock they found that 68% were hypocalcaemic. 16 Haghbin et al mentioned that the prevalence of hyperglycemia and hypocalcaemia in critically ill patients is considerable with no link to ventilation. 12 Table 4 Comparison between hypocalcemia and normocalcemia on admission.…”

Section: Discussionmentioning

confidence: 99%

“…15 Different levels of magnesium were mentioned in the literature from 11% to 60% of PICU admissions. 16,18 Hypomagnesaemia was common in severe sepsis and septic shock. 17 Hypomagnesemia promotes low-grade inflammation as demonstrated by elevated concentrations of C-Reactive Protein (CRP) and TNF-a.…”

Section: Discussionmentioning

confidence: 99%

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Calcium, magnesium and phosphorus deficiency in critically ill children

Beleidy

Sherbini

El-Gebaly

et al. 2017

Egyptian Pediatric Association Gazette

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a b s t r a c tIntroduction: Critical illness may trigger an acute phase response which is associated with several metabolic derangements. These include hypo-and hypercalcemia, hypo-and hyperphosphatemia, hypo-and hypomagnesaemia. Method: Therefore, we conducted a prospective, non-interventional study in 10 beds intensive care unit of the at Pediatric Intensive Care Unit, Cairo University Pediatric Hospital. During 6 months period to investigate the incidence & risk factors of magnesium, phosphorus & calcium deficiency in patients admitted to the intensive care unit (ICU) on admission and followed the course of deficiency at day 3 & ten during stay. Results: Out of 70 patients, the frequency of Calcium deficiency was (34%), magnesium deficiency (31%), phosphorus deficiency (47%) on admission. Calcium and magnesium deficiency frequency changed gradually after 72 h & 10 days; in response to intravenous supplementation for deficient patients. While phosphorus level declined during follow up. Respiratory failure (87%) was the most common organ failure followed by neurological failure. Patients with hypocalcaemia on admission had a higher PELOD score (P = 0.10), coagulopathy (P = 0.044), sepsis diagnoses (P = 0.007), metabolic acidosis (P = <0.001), hyperglycemia (P = 0.006) hypomagnesaemia (P = <0.001), hypoalbuminemia (P = 0.004). While hypomagnesaemia risk factors were coagulopathy (P = 0.039), inborn error of metabolism (P = 0.039), sepsis diagnoses (P = 0.045), hypocalcaemia (P = <0.001), hypophosphatemia (P = 0.004), hypoalbuminemia (P = 0.042). Hypophosphatemia was associated with hypokalemia (P = 0.003) & hypomagnesaemia (P = 0.004). Regression analysis revealed metabolic acidosis & hyperglycemia were associated with calcium deficiency, while inborn error of metabolism and hypophosphatemia with magnesium deficiency. Risk factors for Hypophosphatemia are hypokalemia & hypomagnesaemia. Conclusion: Hypophosphatemia was the most frequent and under estimated electrolyte disturbance in our study. Ó 2017 The Egyptian Pediatric Association. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). IntroductionDisorders of magnesium, calcium and phosphorus are common in patients admitted to intensive care units. 1 Routine monitoring and replacement of these ions are still underemphasized. 2 Most studies focus, on individual electrolytes without taking the interrelationship between specific deficits into account. Hypocalcaemia is a common derangement in both medical and surgical patients requiring intensive care. The reported prevalence varies significantly between studies due to differences in the population studied and the cutoff values used, with published figures ranging from 15% to 88%. 3 Magnesium is the fourth most common cation in the body and second most common intracellular cation after potassium, yet its deficiency is frequently overlooked. Various studies have reported the incidence of hypomagnesemia up to 65% in ...

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Calcium, magnesium and phosphorus deficiency in critically ill children

Beleidy

Sherbini

El-Gebaly

et al. 2017

Egyptian Pediatric Association Gazette

View full text Add to dashboard Cite

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“…In another study (68%) were hypocalcemic (19 survivors and 7 non-survivors). 27 Clinical suspicion is very important for identification of electrolyte imbalance in these patients. :Electrolyte imbalances are common in children with different types of infections, especially in diarrhea with specific symptoms of electrolyte abnormality often merged with the underlying disease.…”

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confidence: 99%

Electrolyte imbalance in hospitalized children with infections - a tertiary care Experience

Hassan,

Khan,

Mukti

et al. 2024

Northern Int. Med. Coll. J.

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Background: Electrolyte imbalances are a common finding in hospitalized children, especially those with infections. Infections interfere with the body's normal fluid and electrolytes balance as well as various factors also contribute to electrolyte imbalances. Sometimes medicine used in the treatment of infections contributes in electrolyte abnormalities. Usually, the types of electrolyte abnormalities found among the hospital admitted children with infections are Hyponatremia, Hypernatremia, Hypokalemia, Hyperkalemia, Hypocalcemia etc. Objective: To find out the types of electrolyte imbalance in hospitalized children with infection. Methodology: This is a hospital based cross sectional study conducted from 1st April 2019 to 31st March 2020 at Ad-Din Women’s Medical College Hospital. A total of 120 children who met the inclusion criteria were enrolled for the study. Children aged 1 to 12 years, who were admitted into Pediatric ward with clinical diagnosis of septicemia with septic shock or with different bacterial infections were included in this study. Children with non-infectious diseases, Syndromic children, with prolonged medications like diuretics, steroids, chronic diseases, kidney diseases, protein energy malnutrition were excluded from this study. During admission, all suspected cases of infections were advised to do sepsis screening and serum electrolytes (serum sodium (Na+), serum potassium (K+), sometimes serum calcium (C-). At the time of admission, who were not investigated for electrolytes; they were also advised for electrolytes (several times) during his/her hospital stay particularly who were on intravenous fluid for more than 3 days without any enteral feed. Data were collected by clinical interview, physical examination and lab investigations report using a pretested structured questionnaire. All data was entered in a master chart in Microsoft Excel sheet and was analyzed in SPSS 21.0 software. Result: Total 120 children were enrolled in this study, age ranges from 1 month to 12 years. Male 68(56.66%) and female 52(43.33%) with male female ratio 1.3 :1. Infants from 1 month to 1 year 68(56.66%), from 1 year to 5 year 38(32.66%) and 5years up to 12 years 14 (11.66%). Children had the following clinical presentations -fever in 52(43.33%) cases , reluctant to take feed 32(26.66%) vomiting 52 (43.33%), lethargy 23(19%), loose motion 60(50%), abdominal pain 14(11.66%), cough and respiratory distress 20(16.66%),tetany/convulsion 21(17.5%), unconsciousness 10(8.33%). History of taking in appropriately prepared ORS 17(14.66%) and concentrated ORS were present in 11(9.1%) cases. Clinical diagnosis was septicemia with or without septic shock, with blood culture positive10(8.3%), diarrhea/invasive diarrhea 58(48.33%), enteric fever 10(8.3%), pneumonia 6(5%),UTI/ Urosepsis 4(3.33%), Meningitis/ meningoencephalitis 8(6.66%), TBM 2(1.6%), dengue fever 6(5%), probable bacterial infections 8(6.66%) Among 120 cases serum Na <135mmol/l were in 34(28.33%) cases, from 135 to 145mmol/l were in 38(31.66%) but they had isolated hypokalemia. Mild hypernatremia were in 18(15%), moderate hypernatremia was in 24(20%) and severe hypernatremia were in 6(5%). Hypokalemia found in 70(58.33%)cases, Hyperkalemia present in 8(6.66%) and normal potassium were in 42(35%) cases, but they had isolated Hypernatremia or Hyponatremia. Chloride levels between 99 to 106mmol/l were in 40(33.33%) cases,<99mmol/l were in 30(25%) cases and >105mmmol/l were in 50(41.66%) cases. Conclusion : Electrolyte imbalances are common in children with different types of infections specially in diarrhea with severe dehydration. Specific symptoms of electrolyte abnormality often merged with the underlying disease. A high index of suspicion is very important for identification of electrolyte imbalance. Northern International Medical College Journal Vol. 13 No. 1-2 July 2021-January 2022, Page 588-593

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Hypocalcemia in children with septic shock

Abstract: P14 Facial continuous positive airway pressure therapy for cardiogenic pulmonary oedema: a study of its efficacy in an emergency department setting within the UK

Cited by 2 publications

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Calcium, magnesium and phosphorus deficiency in critically ill children

Calcium, magnesium and phosphorus deficiency in critically ill children

Electrolyte imbalance in hospitalized children with infections - a tertiary care Experience

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