OBJECTIVE: To evaluate whether calcium adjusted for albumin can be used to monitor calcium homeostasis in critically ill patients. DESIGN: Prospective single-single center observational study. SETTING: Clinical laboratory and critical care unit of a regional teaching hospital. PATIENTS: Fifty-three paired samples were from 36 patients requiring intensive care treatment. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Total 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. CONCLUSIONS: Albumin-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.
OBJECTIVE: To evaluate whether calcium adjusted for albumin can be used to monitor calcium homeostasis in critically illpatients. DESIGN: Prospective single-single center observational study. SETTING: Clinical laboratory and critical care unit of a regional teaching hospital. PATIENTS: Fifty-three paired samples were from 36 patients requiring intensive care treatment. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Total calcium, albumin-adjusted calcium, and ionizedcalcium were measured in critically illpatients during an 8-wk period. Calcium was adjusted for albumin using the formula that is most frequently used in The Netherlands. Using ionizedcalcium 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. CONCLUSIONS: Albumin-adjusted calcium cannot be used in an intensive care setting to monitor reliably the calcium levels in critically illpatients and should be replaced by measurement of ionizedcalcium.
Authors: Walter M van den Bergh; Jolanda M W van de Water; Reinier G Hoff; Ale Algra; Gabriel J E Rinkel Journal: Neurocrit Care Date: 2008 Impact factor: 3.210
Authors: Andrea Morotti; Andreas Charidimou; Chia-Ling Phuah; Michael J Jessel; Kristin Schwab; Alison M Ayres; Javier M Romero; Anand Viswanathan; M Edip Gurol; Steven M Greenberg; Christopher D Anderson; Jonathan Rosand; Joshua N Goldstein Journal: JAMA Neurol Date: 2016-11-01 Impact factor: 18.302