Low Plasma Ionized Calcium and Response to Calcium Therapy in Critically Ill Man

Drop, Lambertus J.; Laver, Myron B.

doi:10.1097/00000542-197509000-00005

Cited by 100 publications

(27 citation statements)

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“…33 Ionized serum calcium is closely regulated by the endocrine system and is a better indicator of the functional status of calcium metabolism than total calcium levels. Because of the poor correlation between ionized calcium and total calcium levels, especially in ICU patients with hypoalbuminemia or acid-base imbalance, 145 direct measurement of ionized calcium concentration in critically ill ICU patients is recommended. [32][33][34][35] The normal range for ionized serum calcium concentration is 1.12-1.30 mmol/L.…”

Section: Calciummentioning

confidence: 99%

Treatment of electrolyte disorders in adult patients in the intensive care unit

Kraft

Btaiche²,

Sacks³

et al. 2005

American Journal of Health-System Pharmacy

241

202

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Purpose. The treatment of electrolyte disorders in adult patients in the intensive care unit (ICU), including guidelines for correcting specific electrolyte disorders, is reviewed. Summary. Electrolytes are involved in many metabolic and homeostatic functions. Electrolyte disorders are common in adult patients in the ICU and have been associated with increased morbidity and mortality, as has the improper treatment of electrolyte disorders. A limited number of prospective, randomized, controlled studies have been conducted evaluating the optimal treatment of electrolyte disorders. Recommendations for treatment of electrolyte disorders in adult patients in the ICU are provided based on these studies, as well as case reports, expert opinion, and clinical experience. The etiologies of and treatments for hyponatremia hypotonic and hypernatremia (hypovolemic, isovolemic, and hypervolemic), hypokalemia and hyperkalemia, hypophosphatemia and hyperphosphatemia, hypocalcemia and hypercalcemia, and hypomagnesemia and hypermagnesemia are discussed, and equations for determining the proper dosages for adult patients in the ICU are provided. Treatment is often empirical, based on published literature, expert recommendations, and the patient's response to the initial treatment. Actual electrolyte correction requires individual adjustment based on the patient's clinical condition and response to therapy. Clinicians should be knowledgeable about electrolyte homeostasis and the underlying pathophysiology of electrolyte disorders in order to provide the optimal therapy to patients. Conclusion. Treatment of electrolyte disorders is often empirical, based on published literature, expert opinion and recommendations, and patient's response to the initial treatment. Clinicians should be knowledgeable about electrolyte homeostasis and the underlying pathophysiology of electrolyte disorders to provide optimal therapy for patients.

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Section: Calciummentioning

confidence: 99%

Treatment of electrolyte disorders in adult patients in the intensive care unit

Kraft

Btaiche²,

Sacks³

et al. 2005

American Journal of Health-System Pharmacy

241

202

View full text Add to dashboard Cite

show abstract

“…Ionized hypocalcemia is common in critically ill (2)(3)(4)(5)(6)(7)(8)(9) and septic (8, 10 -14 ) patients, and iCa monitoring and calcium supplementation are undertaken in such patients to avoid the effects of low calcium, which can include cardiovascular and neuromuscular compromise. Ionized hypocalcemia caused by massive blood transfusion and plasmapheresis transiently reduces the iCa fraction in serum or plasma by virtue of the chelating action of the citrate contained in blood products.…”

mentioning

confidence: 99%

Reducing Routine Ionized Calcium Measurement

et al. 2009

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“…11 In critically ill surgical patients, corrected total calcium measurements poorly correlate with hypocalcemia. [13][14][15] In this clinical setting, hypoalbuminemia, acidemia, acute elevations of free fatty acid concentrations, and lipid infusions during parenteral nutrition may result in poor correlation of total calcium with direct measurements of ionized calcium. 16 -18 Hypocalcemia is common in intensive care units, where corrected serum calcium levels fail to classify accurately as many as 40% of cases of hypocalcemia.…”

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confidence: 99%