Clinical PotpourriIonized hypocalcemia is an early event and is associated with organ dysfunction in children admitted to the intensive care unit
Section snippets
Methods
A prospective cohort study of children admitted consecutively to the pediatric ICU of a teaching hospital was carried out in which serum calcium concentrations were monitored during the first 10 days of the hospital stay. All patients with a previous diagnosis of chronic renal failure, hypoparathyroidism, or brain death and those lacking data on ionized calcium levels were excluded from the study. The study site was a high-complexity unit, classed as Level 1 A according to the guidelines of the
Results
Of a total of 475 children admitted to the ICU between January 2006 and January 2008, 27 patients were excluded because of chronic renal disease, 6 because of brain death on admission, and 105 because of lack of ionized calcium data (only total calcium available) for the first 3 days of the hospital stay, giving a final sample of 337 patients. Patients had been referred from the surgical ward (42.9%), emergency department (23%), and semi-ICU (12.8%). The main characteristics of the patients are
Discussion
Hypocalcemia was common in the ICU, occurring in 77.15% of patients during the study period. This result is consistent with the findings of other studies in the literature showing a hypocalcemia frequency of between 18% and 74% among ICU patients [10], [11], [12]. However, in the cited reports, hypocalcemia was determined based on either total or ionized calcium concentrations. In the present study, the diagnosis of hypocalcemia was reached based only on ionized calcium because this represents
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