The significance of ionized calcium in cardiac and critical care

Availability and critical limits at US medical centers and children's hospitals

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

The clinical use of ionized calcium has increased since the recognition of its importance in cardiac and critical care medicine. However, more than half the general medical centers in the United States do not provide immediate testing of ionized calcium levels in patients in critical care settings, although indications for this test indicate that they should. The following objectives were used in this study: (1) to determine the availability of ionized calcium testing; (2) to document appropriate critical limits; and (3) to describe the significance of ionized hypocalcemia in cardiac and critical care. The participants were 100 medical centers and 40 children's hospitals in the United States. At medical centers, mean (±SD) critical limits were as follows: low, 0.82±0.14 mmol/L (3.29±0.56 mg/dL); and high, 1.55±0.19 mmol/L (6.21±0.76 mg/dL). At children's hospitals, mean critical limits were as follows: low, 0.85±0.13 mmol/L (3.41±0.52 mg/dL); and high, 1.53±0.11 mmol/L (6.13±0.44 mg/dL). In the past decade, the availability of ionized calcium testing increased dramatically. Now, 57%, 86%, 95%, and 100% of general hospitals, heart transplant centers, children's hospitals, and pediatric heart transplant centers, respectively, perform testing in house. Collective experience indicates that (1) aggressive monitoring of ionized calcium prevents cardiac (and neurologic) catastrophes, (2) appropriate levels optimize cardiac function, and (3) calcium repletion is safest when based on acute trends measured directly in whole blood. Hospitals should provide rapid response testing needed during transplantation and massive transfusion and for the diagnosis and treatment of acute ionized hypocalcemia.

Original languageEnglish (US)
Pages (from-to)890-896
Number of pages7
JournalArchives of Pathology and Laboratory Medicine
Volume117
Issue number9
StatePublished - 1993

Fingerprint

Critical Care
Calcium
Hypocalcemia
Transplants
Pediatric Hospitals
General Hospitals
Nervous System
Transplantation
Medicine

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Cite this

@article{182f66eb47a94fa283576e17861fa5b8,
title = "The significance of ionized calcium in cardiac and critical care: Availability and critical limits at US medical centers and children's hospitals",
abstract = "The clinical use of ionized calcium has increased since the recognition of its importance in cardiac and critical care medicine. However, more than half the general medical centers in the United States do not provide immediate testing of ionized calcium levels in patients in critical care settings, although indications for this test indicate that they should. The following objectives were used in this study: (1) to determine the availability of ionized calcium testing; (2) to document appropriate critical limits; and (3) to describe the significance of ionized hypocalcemia in cardiac and critical care. The participants were 100 medical centers and 40 children's hospitals in the United States. At medical centers, mean (±SD) critical limits were as follows: low, 0.82±0.14 mmol/L (3.29±0.56 mg/dL); and high, 1.55±0.19 mmol/L (6.21±0.76 mg/dL). At children's hospitals, mean critical limits were as follows: low, 0.85±0.13 mmol/L (3.41±0.52 mg/dL); and high, 1.53±0.11 mmol/L (6.13±0.44 mg/dL). In the past decade, the availability of ionized calcium testing increased dramatically. Now, 57{\%}, 86{\%}, 95{\%}, and 100{\%} of general hospitals, heart transplant centers, children's hospitals, and pediatric heart transplant centers, respectively, perform testing in house. Collective experience indicates that (1) aggressive monitoring of ionized calcium prevents cardiac (and neurologic) catastrophes, (2) appropriate levels optimize cardiac function, and (3) calcium repletion is safest when based on acute trends measured directly in whole blood. Hospitals should provide rapid response testing needed during transplantation and massive transfusion and for the diagnosis and treatment of acute ionized hypocalcemia.",
author = "Kost, {Gerald J}",
year = "1993",
language = "English (US)",
volume = "117",
pages = "890--896",
journal = "Archives of Pathology and Laboratory Medicine",
issn = "0003-9985",
publisher = "College of American Pathologists",
number = "9",

}

TY - JOUR

T1 - The significance of ionized calcium in cardiac and critical care

T2 - Availability and critical limits at US medical centers and children's hospitals

AU - Kost, Gerald J

PY - 1993

Y1 - 1993

N2 - The clinical use of ionized calcium has increased since the recognition of its importance in cardiac and critical care medicine. However, more than half the general medical centers in the United States do not provide immediate testing of ionized calcium levels in patients in critical care settings, although indications for this test indicate that they should. The following objectives were used in this study: (1) to determine the availability of ionized calcium testing; (2) to document appropriate critical limits; and (3) to describe the significance of ionized hypocalcemia in cardiac and critical care. The participants were 100 medical centers and 40 children's hospitals in the United States. At medical centers, mean (±SD) critical limits were as follows: low, 0.82±0.14 mmol/L (3.29±0.56 mg/dL); and high, 1.55±0.19 mmol/L (6.21±0.76 mg/dL). At children's hospitals, mean critical limits were as follows: low, 0.85±0.13 mmol/L (3.41±0.52 mg/dL); and high, 1.53±0.11 mmol/L (6.13±0.44 mg/dL). In the past decade, the availability of ionized calcium testing increased dramatically. Now, 57%, 86%, 95%, and 100% of general hospitals, heart transplant centers, children's hospitals, and pediatric heart transplant centers, respectively, perform testing in house. Collective experience indicates that (1) aggressive monitoring of ionized calcium prevents cardiac (and neurologic) catastrophes, (2) appropriate levels optimize cardiac function, and (3) calcium repletion is safest when based on acute trends measured directly in whole blood. Hospitals should provide rapid response testing needed during transplantation and massive transfusion and for the diagnosis and treatment of acute ionized hypocalcemia.

AB - The clinical use of ionized calcium has increased since the recognition of its importance in cardiac and critical care medicine. However, more than half the general medical centers in the United States do not provide immediate testing of ionized calcium levels in patients in critical care settings, although indications for this test indicate that they should. The following objectives were used in this study: (1) to determine the availability of ionized calcium testing; (2) to document appropriate critical limits; and (3) to describe the significance of ionized hypocalcemia in cardiac and critical care. The participants were 100 medical centers and 40 children's hospitals in the United States. At medical centers, mean (±SD) critical limits were as follows: low, 0.82±0.14 mmol/L (3.29±0.56 mg/dL); and high, 1.55±0.19 mmol/L (6.21±0.76 mg/dL). At children's hospitals, mean critical limits were as follows: low, 0.85±0.13 mmol/L (3.41±0.52 mg/dL); and high, 1.53±0.11 mmol/L (6.13±0.44 mg/dL). In the past decade, the availability of ionized calcium testing increased dramatically. Now, 57%, 86%, 95%, and 100% of general hospitals, heart transplant centers, children's hospitals, and pediatric heart transplant centers, respectively, perform testing in house. Collective experience indicates that (1) aggressive monitoring of ionized calcium prevents cardiac (and neurologic) catastrophes, (2) appropriate levels optimize cardiac function, and (3) calcium repletion is safest when based on acute trends measured directly in whole blood. Hospitals should provide rapid response testing needed during transplantation and massive transfusion and for the diagnosis and treatment of acute ionized hypocalcemia.

UR - http://www.scopus.com/inward/record.url?scp=0027247779&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027247779&partnerID=8YFLogxK

M3 - Article

VL - 117

SP - 890

EP - 896

JO - Archives of Pathology and Laboratory Medicine

JF - Archives of Pathology and Laboratory Medicine

SN - 0003-9985

IS - 9

ER -