Calcium Homeostasis During Magnesium Treatment in Aneurysmal Subarachnoid Hemorrhage
| Autor: | Jolanda M. W. van de Water, Reinier G. Hoff, Ale Algra, Walter M. van den Bergh, Gabriel J. E. Rinkel |
|---|---|
| Přispěvatelé: | University of Groningen, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Intensive Care Medicine |
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male endocrine system medicine.medical_specialty Subarachnoid hemorrhage Calcitriol subarachnoid hemorrhage PARATHYROID-HORMONE Ischemia Parathyroid hormone chemistry.chemical_element magnesium ILLNESS Calcium Critical Care and Intensive Care Medicine cerebral ischemia Risk Factors Internal medicine medicine Homeostasis Humans parathyroid hormone cardiovascular diseases SULFATE THERAPY SCALE Aged Proportional Hazards Models Calcium metabolism calcium Magnesium business.industry SERUM-CALCIUM Middle Aged medicine.disease HYPOCALCEMIA nervous system diseases Treatment Outcome SEVERITY Endocrinology chemistry Multivariate Analysis Female Neurology (clinical) business CRITICALLY-ILL PATIENTS hormones hormone substitutes and hormone antagonists medicine.drug |
| Zdroj: | Neurocritical care, 8(3), 413-417. Humana Press |
| ISSN: | 1556-0961 1541-6933 |
| Popis: | Objective Magnesium treatment in patients with subarachnoid hemorrhage (SAH) can result in hypocalcemia; this hypocalcemia increases the risk of delayed cerebral ischemia (DCI) and poor outcome. We assessed whether low serum levels of total calcium in patients with SAH treated with magnesium is mediated by parathyroid hormone (PTH) or calcitriol, and whether increased PTH or low serum levels of ionized calcium are associated with an increased risk of DCI and poor outcome.Patients and Methods We studied 167 patients included in a randomized, placebo controlled trial on magnesium in SAH. Mean serum magnesium during treatment was related to mean serum levels of ionized calcium, PTH and calcitriol with linear regression. Hypocalcemia (Ca(2+)) and high serum PTH were related to the occurrence of DCI by means of the Cox proportional hazards model and to poor outcome by logistic regression.Results Serum magnesium was inversely related to ionized calcium (B = -0.1; 95% CI -0.12 to -0.06), but not to PTH or calcitriol. Neither hypocalcemia nor high serum PTH was related to DCI. Hypocalcemia did not increased the risk for poor outcome (OR 1.2; 95% CI 0.6-2.3). In the subgroup of patients with known PTH (n = 67), high serum PTH increased the risk for poor outcome (OR 5.4; 1.6-18.9).Conclusions Magnesium treatment in patients with SAH leads to hypocalcemia without effect on outcome. PTH is related to poor outcome, but this is independent of magnesium therapy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink