Abstract
Normal serum ionized calcium levels are crucial to many aspects of physiologic stability. Disturbances in ionized calcium are known to occur frequently in critically ill adults, and to be poorly predicted by measures of total serum calcium. This study was undertaken to determine the frequency and significance of abnormalities of ionized calcium in critically ill pediatric patients.
Methods. Eighty-eight ionized calcium measurements were obtained on admission of critically ill children to our intensive care unit. Simultaneous measurements of total serum calcium, protein, albumin, pH, electrolytes, and measures of hepatic and renal function were also obtained. Patients were prospectively followed for outcome parameters.
Results. Mean ionized calcium for our patients was 1.21 +/- 0.28 mM/L. 15 patients (17%) had levels outside the normal range for our laboratory with 11 (12.5%) hypocalcemic. Mortality rates were 46%, 9.5% and 0% for the hypo-, normo-, and hypercalcemic patients respectively. The association between hypocalcemia and mortality was highly significant (p<.001). Furthermore, 6/7 patients initially normocalcemic experienced significant hypocalcemia within 24 hours prior to death.
Conclusions. We conclude 1) that derangements in ionized calcium occur frequently in critically ill children, and 2) that hypocalcemia is associated with increased mortality.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Broner, C., Stidham, G. & Westenkirchner, D. SIGNIFICANCE OF IONIZED CALCIUM MEASUREMENTS IN CRITICALLY ILL CHILDREN. Pediatr Res 21 (Suppl 4), 198 (1987). https://doi.org/10.1203/00006450-198704010-00190
Issue Date:
DOI: https://doi.org/10.1203/00006450-198704010-00190