Ionized hypocalcemia is an early event and is associated with organ dysfunction in children admitted to the intensive care unit

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dc.contributor.authorBarbosa Dias, Cacilda Rosa [UNIFESP]
dc.contributor.authorLeite, Heitor Pons [UNIFESP]
dc.contributor.authorNogueira, Paulo Cesar Koch [UNIFESP]
dc.contributor.authorCarvalho, Werther Brunow de [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.date.accessioned2016-01-24T14:34:31Z
dc.date.available2016-01-24T14:34:31Z
dc.date.issued2013-10-01
dc.description.abstractPurpose: the purpose was to determine the frequency and risk factors of ionized hypocalcemia and to evaluate this disturbance as a predictor of mortality in a pediatric intensive care unit (ICU).Materials and Methods: in a prospective cohort study, 337 children admitted consecutively to an ICU were monitored regarding serum ionized calcium concentrations during the first 10 days of admission. the following variables were analyzed as independent of hypocalcemia: age; malnutrition; sepsis; Pediatric Index of Mortality 2; first 3 days organ dysfunction score (Pediatric Logistic Organ Dysfunction); and use of steroids, furosemide, and anticonvulsants. Hypocalcemia was defined as a serum ionized calcium concentration less than 1.15 mmol/L.Results: the rate of hypocalcemia was 77.15%. in a multivariate model, higher Pediatric Logistic Organ Dysfunction scores during the first 3 days of ICU stay were independently associated with hypocalcemia (odds ratio, 2.24; 95% confidence interval, 1.23-4.07; P = .008). Medications associated with hypocalcemia were furosemide (dose >= 2 mg/[kg d]) and methylprednisolone (dose >= 2 mg/[kg d]). No significant association was found between hypocalcemia and 10-day mortality.Conclusions: Ionized hypocalcemia is common during the ICU stay, particularly in the first 3 days of admission. This disturbance was not found to be a predictor of mortality, but it is independently associated with more severe organ dysfunction. (C) 2013 Elsevier Inc. All rights reserved.en
dc.description.affiliationUniversidade Federal de São Paulo, Dept Pediat, Pediat Intens Care Unit, São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Pediat Intens Care Unit, São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Discipline Nutr & Metab, Dept Pediat, São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Dept Pediat, Pediat Nephrol Sect, São Paulo, Brazil
dc.description.affiliationUniv São Paulo, Inst Crianca, BR-05508 São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Pediat, Pediat Intens Care Unit, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Pediat Intens Care Unit, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Discipline Nutr & Metab, Dept Pediat, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Pediat, Pediat Nephrol Sect, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent810-815
dc.identifierhttp://dx.doi.org/10.1016/j.jcrc.2013.03.019
dc.identifier.citationJournal of Critical Care. Philadelphia: W B Saunders Co-Elsevier Inc, v. 28, n. 5, p. 810-815, 2013.
dc.identifier.doi10.1016/j.jcrc.2013.03.019
dc.identifier.issn0883-9441
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/36822
dc.identifier.wosWOS:000324374700038
dc.language.isoeng
dc.publisherElsevier B.V.
dc.relation.ispartofJournal of Critical Care
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.subjectHypocalcemiaen
dc.subjectIntensive care uniten
dc.subjectPediatricen
dc.subjectCritical illnessen
dc.subjectMultiple organ failureen
dc.subjectFurosemideen
dc.subjectSteroidsen
dc.titleIonized hypocalcemia is an early event and is associated with organ dysfunction in children admitted to the intensive care uniten
dc.typeinfo:eu-repo/semantics/article
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