Byrnes Matthew C, Huynh Kahn, Helmer Stephen D, Stevens Christian, Dort Jonathan M, Smith R Stephen
Department of Surgery, Room 3082, The University of Kansas School of Medicine-Wichita, 929 N. Saint Francis St., Wichita, KS 67214, USA.
Am J Surg. 2005 Mar;189(3):310-4. doi: 10.1016/j.amjsurg.2004.11.017.
Aberrations in calcium homeostasis are common in critically ill patients. The proper method to evaluate this issue in surgical patients has not been completely defined.
Medical records of patients admitted to a university-affiliated, tertiary-care surgical intensive care unit were retrospectively reviewed. Calcium status was evaluated by ionized levels and as a function of serum calcium levels corrected for albumin aberrations.
Corrected serum calcium values failed to accurately classify calcium status in 38% of cases. The sensitivity and specificity of the corrected serum calcium formula to evaluate hypocalcemia were 53% and 85%, respectively. Corrected serum values underestimated the prevalence of hypocalcemia and overestimated the prevalence of normocalcemia. No factors were able to discern which patients could be evaluated by corrected serum calcium levels.
Calcium homeostasis should be evaluated by ionized calcium levels rather than as a function of serum calcium and albumin levels.
钙稳态异常在危重症患者中很常见。评估外科患者这一问题的恰当方法尚未完全明确。
回顾性分析一所大学附属医院三级护理外科重症监护病房收治患者的病历。通过离子化水平评估钙状态，并将其作为校正白蛋白异常后的血清钙水平的函数。
校正后的血清钙值在38%的病例中未能准确分类钙状态。校正血清钙公式评估低钙血症的敏感性和特异性分别为53%和85%。校正后的血清值低估了低钙血症的患病率，高估了正常钙血症的患病率。没有因素能够识别哪些患者可以通过校正后的血清钙水平进行评估。
应通过离子钙水平而非血清钙和白蛋白水平的函数来评估钙稳态。
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