Analysis Of The Correlation Between Hypocalcemia And Critically Ill Patients

Objectives The aim of the work is to determine the incidence, risk factors andprognostic value of hypocalcemia in critically ill patients.Patients and methods110critically ill patients were admitted to intensive care unit ofthe General Hospital of Ningxia Medical University and The Cardiovascular andCerebrovascular disease Hospital of Ningxia Medical University between October2012toJuly2013as the case group. The patients were divided into the normal calcium group andhypocalcemia group based on serum calcium level.50healthy people had medicalexaminations in the same two hospitals in the same period as the healthy controls. The bloodsamples were collected from the patients at the first day they admitted, and from the healthycontrols. The biochemical parameters, hemogram, coagulation index, the blood gasanalysis,and PH value were detection. The incidence of hypocalcemia was determined.Multivariable Logistic regression analysis was used to detect the risk factors of hypocalcemia.And Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) score, length of ICUstay, the incidence of MODS, and hospital mortality were compared among patients withdifferent serum calcium levels.Results①The incidence of hypocalcemia in critically ill patients was70.9%, while theincidence in the patients with systemic infection and the patients with trauma was higher,respectively80.9%and79.5%.②Multivariable Logistic regression analysis was used amongthe examined factors and the result showed that hypoalbuminemia, hyperlactatemia, elevated INR, elevated D-dimer, and vitamin D deficiency are the independent risk factors associatedwith hypocalcemia of the critically ill patients(P＜0.05).③APACHE Ⅱscore, length of ICUstay, the incidence of MODS, and hospital mortality were significantly different on differentserum calcium levels(P＜0.05).Conclusions1. The incidence of hypocalcemia in critically ill patients is high, with thehighest rates observed in systemic infection patients and trauma patients.2. hypoalbuminemia,hyperlactatemia, elevated INR, elevated D-dimer, and vitamin D deficiency are theindependent risk factors associated with hypocalcemia of the critically ill patients.3.Hypocalcemia can aggravate the severity of disease, prolonged hospitalization in ICU,increase the incidence of MODS, and hospital mortality. Objectives To clarify the intra and extra changes of calcium ion in critically ill patientsand its significance.Patients and methods100critically ill patients were admitted to intensive care unit ofthe General Hospital of Ningxia Medical University and The Cardiovascular andCerebrovascular disease Hospital of Ningxia Medical University between October2012toJuly2013as the case group. The patients were divided into the normal calcium group andhypocalcemia group based on serum calcium level.50healthy people had medicalexaminations in the same two hospitals in the same period as the healthy controls. The bloodsamples were collected from the patients and the healthy controls to evaluate the activity oferythrocyte membrane-Ca pump and concentration of intra, extra-cellular calcium ion, MCV,RDW, serum bilirubin level. The activity of erythrocyte membrane-Ca pump andconcentration of intra, extra-cellular calcium ion, MCV, RDW, serum bilirubin level werecompared among patients with different groups.Results①The Critically ill patients demonstrated higher concentrations of extra-cellular calcium ion and lower activities of erythrocyte membrane-Ca pump compared withthe the healthy controls;So did the hypocalcemia group compared with the normal calciumgroup(P＜0.05).The serum calcium levels was correlated positively with the activity oferythrocyte membrane-Ca pump(r＝0.547,P＜0.01),and was correlated negatively with the concentrations of extra-cellular calcium ion(r＝-0.558,P＜0.05).②The hypocalcemiagroup demonstrated higher level of MCV and RDW than the other two groups(P＜0.05).Butthere were no differences in level of MCV and RDW between the normal calcium group andthe healthy controls(P＞0.05). The higher level of serum bilirubin on the hypocalcemia groupwas compared with the other two groups. So did the normal calcium group (P＜0.05).Conclusions1.A decrease in activities of erythrocyte membrane-Ca pump may causecalcium moving into intra-cell from extra-cell, which is one of mechanisms that occurredhypocalcemia for critically ill patients.2. Calcium flowing into intra-cell from extra-cellmay result in higher RBC MCV, RDW. And under the action of shear forces to make it easyto red blood cell disruption,thus leading to hemolysis and then causing the increase of serumbilirubin level.