| Abstrakt: |
Background: The incidence of hypocalcemia in critically ill patients varies widely depending on the different underlying diseases and comorbidity. The aim of the study is early prediction of cases of hypocalcemia for better management and to improve morbidity and mortality in patients of surgical intensive care unit of Zagazig University Hospitals. Patients and methods: A prospective cohort study included 310 patients and was carried out in the surgical intensive care unit of Zagazig University Hospitals over a period of six month. Total serum calcium concentration was measured colorimetrically, whereas the serum ionized calcium concentration was measured using an ion-selective electrode method. Results: The present study included 310 patients who were admitted to ICUand their calcium level was measured. The mean age of the studied cases was 50.58±14.31 years ranging from 22 to 80 years, 51% were females and mean duration of ICU admission was 7.12±2.45 days ranging from 3 to 14 days. About 41% of the cases developed hypocalcemia on the third day of follow up and 59% of the studied cases developed hypocalcemia on the 5th day of follow up. The current demonstrate that 40% of the studied cases were admitted to ICU due to sepsis and septic shock, 16% polytrauma, 10% respiratory failure, 10% post-operative monitoring, 6% with ICH, 6% with uncontrolled HTN, 4%with ischemic stroke, 2% pancreatitis, 2% dehydration & electrolyte imbalance, 2% DKA and one case due to organophosphorus poisoning and 1% rhabdomyolysis. The mean GCS was 11.79±2.16 ranging from 6 to 15, mean APACHE2 score was44.25±18.7 ranging from 2 to 50, mean creatinine 1.64±1.36 ranging from 0.5 to 6.3, mean Urea 43.22±41.6 ranging from 12 to 170, mean albumin 3.43±.64 ranging from 2 to 5, mean Ph 3.46±.5 ranging from 2.6 to 4.5 and mean Mg was 1.88±.29ranging from 1.2 to 2.6. The present study showed 82% of the studied cases were treated with heparin, 79% with PPI, 21% diuretics and 18% aminoglycosides. Conclusion: Hypocalcemia is a frequent complication that could be encountered in the critically ill patients. Based on our findings incidence rate of hypocalcemia at 5th day of ICU admission is (59%) which is larger than that at 3rd day (41%). [ABSTRACT FROM AUTHOR] |
