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Treatment of Moderate to Severe Acute Hypocalcemia in Critically Ill Trauma Patients
Author(s) -
Dickerson Roland N.,
Morgan Laurie M.,
Croce Martin A.,
Minard Gayle,
Brown Rex O.
Publication year - 2007
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607107031003228
Subject(s) - critically ill , medicine , intensive care medicine , critical illness , severe trauma , surgery
Background: Our recent data indicate that 21% of critically ill, adult, multiple‐trauma patients receiving specialized nutrition support experience hypocalcemia. However, evidence‐based methods for the treatment of moderate to severe acute hypocalcemia (ionized calcium concentration [iCa]<1 mmol/L) are lacking. Methods: The efficacy of an infusion of 4 g of calcium gluconate was evaluated in 20 critically ill, adult, multiple‐trauma patients with moderate to severe hypocalcemia (iCa <1 mmol/L). The calcium gluconate was infused at a rate of 1 g/h in a small volume admixture. A serum iCa determination was obtained on the following day. Results: Calcium gluconate infusion significantly increased serum iCa from 0.90 ± 0.08 mmol/L to 1.16 ± 0.11 mmol/L ( p < .001) on the following day. This dosage regimen was successful for achieving a serum iCa >1 mmol/L for 19 of 20 (95%) hypocalcemic patients and achieved a concentration >1.12 mmol/L in 14 (70%) of the patients. Two patients developed mild hypercalcemia (iCa of 1.34 mmol/L and 1.38 mmol/L) postinfusion. Conclusions: A short‐term infusion of 4 g of intravenous (IV) calcium gluconate for the treatment of moderate to severe hypocalcemia appears to be a promising regimen for critically ill, adult, multiple‐trauma patients.