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Treatment of acute hypocalcemia in critically ill multiple-trauma patients.
- Source :
-
JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2005 Nov-Dec; Vol. 29 (6), pp. 436-41. - Publication Year :
- 2005
-
Abstract
- Background: Recent data indicate that critically ill, adult multiple trauma patients receiving specialized nutrition support commonly experience hypocalcemia (ionized serum calcium [iCa] < or =1.12 mmol/L). However, validated methods for the treatment of acute hypocalcemia are lacking.<br />Methods: The efficacy of a single dose of calcium gluconate using an empiric IV calcium gluconate graduated dosing regimen was evaluated in 37 patients. Patients with an iCa of 1-1.12 mmol/L (mild hypocalcemia) were provided 1-2 g of IV calcium gluconate. Patients with an iCa of <1 mmol/L (moderate to severe hypocalcemia) were given 2-4 g. The calcium gluconate was infused at a rate of 1 g/h in a small-volume admixture. Serum iCa determination was repeated on the following day.<br />Results: One to 2 g of IV calcium gluconate was effective in normalizing iCa for 23 out of 29 patients (79%) with mild hypocalcemia and 2-4 g was effective for 3 of 8 patients (38%) with moderate to severe hypocalcemia. The individual response to calcium therapy (g/d) or when normalized to body weight (mg/kg/d) was highly variable.<br />Conclusions: One to 2 g of IV calcium gluconate were effective for most patients with mild hypocalcemia; however, treatment of moderate to severe hypocalcemia with 2-4 g of IV calcium gluconate was often unsuccessful. Further study with frequent serial ionized serum calcium and phosphorus determinations and electrocardiographic monitoring appears to be indicated for patients with moderate to severe hypocalcemia.
- Subjects :
- Acute Disease
Dose-Response Relationship, Drug
Female
Humans
Hypocalcemia etiology
Infusions, Intravenous
Intensive Care Units
Male
Middle Aged
Treatment Outcome
Calcium Gluconate therapeutic use
Critical Illness therapy
Hypocalcemia drug therapy
Multiple Trauma therapy
Nutritional Support adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 0148-6071
- Volume :
- 29
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- JPEN. Journal of parenteral and enteral nutrition
- Publication Type :
- Academic Journal
- Accession number :
- 16224037
- Full Text :
- https://doi.org/10.1177/0148607105029006436