Decision points in hypocalcemia: is emergent therapy required? Complications may include tetany, seizures, and arrhythmias.

Decision points in hypocalcemia: is emergent therapy required? Complications may include tetany, seizures, and arrhythmias.

Rutecki G W; Whittier F C

Journal of Critical Illness

1998

1998-02

When a patient's total serum calcium level drops below 8.9 mg/dL, first determine whether the hypocalcemia is real. Measure the serum level of ionized calcium or (because 40% of calcium is bound to protein) adjust the total serum calcium level for changes in serum protein concentrations. This helps determine whether the calcium imbalance is severe and whether emergent treatment (with infusions of elemental calcium) is required. Symptoms and signs of neuromuscular irritability, such as Chvostek's sign and Trousseau's sign, point to true hypocalcemia. Hypomagnesemia often accompanies–and even may cause–hypocalcemia; when the serum magnesium level falls below the normal limit, the ability of the parathyroid hormone to stimulate osteoclast growth and activity can be diminished.

Inpatients; Diagnosis; Laboratory; Hypocalcemia – Diagnosis; Hypocalcemia – Symptoms; Hypocalcemia – Therapy; Hypoparathyroidism – Complications; Magnesium – Administration and Dosage; Pancreatitis – Complications

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