Albumin-adjusted calcium is not suitable for diagnosis of hyper- and hypocalcemia in the critically ill
作者:
Jennichjen Slomp,
Peter van der Voort,
Rik Gerritsen,
Jan Berk,
Andries Bakker,
期刊:
Critical Care Medicine
(OVID Available online 2003)
卷期:
Volume 31,
issue 5
页码: 1389-1393
ISSN:0090-3493
年代: 2003
出版商: OVID
关键词: ionized calcium;total calcium;albumin;hypocalcemia;hypercalcemia;intensive care;critically ill
数据来源: OVID
摘要:
ObjectiveTo evaluate whether calcium adjusted for albumin can be used to monitor calcium homeostasis in critically ill patients.DesignProspective single-single center observational study.SettingClinical laboratory and critical care unit of a regional teaching hospital.PatientsFifty-three paired samples were from 36 patients requiring intensive care treatment.InterventionsNone.Measurements and Main ResultsTotal calcium, albumin-adjusted calcium, and ionized calcium were measured in critically ill patients during an 8-wk period. Calcium was adjusted for albumin using the formula that is most frequently used in The Netherlands. Using ionized calcium as the gold standard, albumin-adjusted calcium overestimated hypercalcemia and totally missed hypocalcemia. The same seemed to be true for other formulas used for albumin or protein adjustment of calcium concentrations.ConclusionsAlbumin-adjusted calcium cannot be used in an intensive care setting to monitor reliably the calcium levels in critically ill patients and should be replaced by measurement of ionized calcium.
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