COVID-19 患者长期入住 ICU 相关的固定性高钙血症。
Immobilization-Related Hypercalcemia in a COVID-19 Patient With Prolonged Intensive Care Unit Stay.
机构信息
From the Intensive Care Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium (J-BM, CC, P-FL, PH); and Louvain Centre for Toxicology and Applied Pharmacology, Université catholique de Louvain, Brussels, Belgium (PH).
出版信息
Am J Phys Med Rehabil. 2022 Jan 1;101(1):61-63. doi: 10.1097/PHM.0000000000001907.
Immobilization-related hypercalcemia is an uncommon finding in patients admitted to intensive care unit. We report a case of severe hypercalcemia in a COVID-19 patient admitted to intensive care unit for hypoxemic respiratory failure. He developed an acute kidney injury requiring continuous renal replacement therapy with regional citrate anticoagulation. Citrate chelates ionized calcium and stop the coagulation cascade locally, preventing filter clotting. Calcium is then given intravenously to a specific target (normocalcemia). It is only when calcium infusion has been stopped that bone resorption and hypercalcemia were unmasked.
在入住重症监护病房的患者中，与固定相关的高钙血症是一种罕见的发现。我们报告了一例 COVID-19 患者因低氧性呼吸衰竭入住重症监护病房后发生严重高钙血症的病例。该患者发生急性肾损伤，需要连续肾脏替代治疗，并采用局部枸橼酸盐抗凝。枸橼酸盐螯合离子钙并局部阻止凝血级联反应，防止滤器凝血。然后静脉内给予钙以达到特定目标（血钙正常）。只有在停止钙输注后，骨吸收和高钙血症才会显现。
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