Ionized Calcium, Cardiac Function, and Electrocardiogram in Preterm Neonates

PEDIATRICS ◽  
1986 ◽  
Vol 78 (3) ◽  
pp. 541-542
Author(s):  
JENS MÖLLER ◽  
F. K. TEGTMEYER
Keyword(s):  
Cardiac Function ◽  
Causal Relationship ◽  
Serum Calcium ◽  
Cardiac Failure ◽  
Calcium Level ◽  
Ionized Calcium ◽  
Preterm Neonates ◽  
Total Serum ◽  
Total Serum Calcium

To the Editor.— We would like to add some comments on the article by Venkataraman et al.1 In one respect it might be quite dangerous not to measure the ionized calcium in preterm neonates. If you find prolongation of QTc or QoTc intervals in the ECG during cardiac failure in these infants and find subnormal total serum calcium levels, you might make a wrong conclusion on causal relationship. Until now, we have seen five preterm neonates with OTc/QoTc prolongation and profound low total serum calcium levels, whereas the measured ionized calcium level was normal.

scholarly journals Association of dietary calcium intake, total and ionized serum calcium levels with preeclampsia in Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rahel D. Gebreyohannes ◽  
Ahmed Abdella ◽  
Wondimu Ayele ◽  
Ahizechukwu C. Eke
Keyword(s):  
Serum Calcium ◽  
Calcium Intake ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Dietary Calcium ◽  
Ionized Calcium ◽  
Dietary Calcium Intake ◽  
Total Serum ◽  
Total Serum Calcium ◽  
Total Serum Calcium Level

Abstract Background Preeclampsia is a well-known cause of maternal mortality and morbidity in Ethiopia. The exact pathophysiology has not been fully understood. Calcium and magnesium deficiencies have been given emphasis to play roles in the pathophysiology. Although evidence is abundant, they are equivocal. The study aimed to see the association of dietary calcium intake, serum total calcium level and ionized calcium level with preeclampsia. It also evaluated the association between dietary calcium intake and serum calcium levels. Materials and methods An unmatched case–control study was conducted in Gandhi Memorial, Tikur Anbessa, and Zewditu Memorial Hospitals, all in Addis Ababa, between October to December, 2019. Cases were 42 women with preeclampsia and controls were 42 normotensive women. The medical and obstetric history was gathered using a structured questionnaire and the dietary calcium intake information using a 24-h dietary recall. The serum levels of total serum calcium and ionized (free) calcium were measured using an inductively coupled mass spectrophotometer. Bivariate and multivariate logistic regression and Pearson correlation test were utilized during data analysis. Results In comparison with controls, women with preeclampsia had lower mean (± 1SD) levels of ionized calcium level (1.1 mmol/l ± 0.11), total serum calcium level (1.99 mmol/l ± 0.35) and lower median (IQR) dietary calcium intake (704 mg/24 h,458–1183). The odds of having preeclampsia was almost eight times greater in those participants with low serum ionized calcium level (OR 7.5, 95% CI 2.388–23.608) and three times higher in those with low total serum calcium level (OR 3.0, 95% CI 1.024–9.370). Low dietary calcium intake also showed statistically significant association with preeclampsia (OR 3.4, 95% CI 1.092 -10.723). Serum ionized calcium level and total serum calcium level showed positive correlation of moderate strength (p = 0.004, r = 0.307), but no correlation was found between dietary calcium intake with both forms of serum calcium levels. Conclusion This study showed significant association between low dietary calcium intake and low serum calcium levels with preeclampsia, hence this can be used as a supportive local evidence for the current context-specific recommendation of calcium supplementation in societies with low-dietary calcium consumption in an attempt to prevent preeclampsia, therefore implementation study should be considered in Ethiopia to look for the feasibility of routine supplementation.

scholarly journals Non-corrected total serum calcium sufficiently reflects ionized calcium level.

2002 ◽  
Vol 35 (12) ◽  
pp. 1523-1525
Author(s):  
Naganori Sato ◽  
Yoshitaka Maeda ◽  
Tatsuo Shiigai
Keyword(s):  
Serum Calcium ◽  
Calcium Level ◽  
Ionized Calcium ◽  
Total Serum ◽  
Total Serum Calcium

scholarly journals SUN-LB67 Revisit Serum Calcium Correction

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Yulong Li ◽  
JunJia Zhu ◽  
Jenny Blau ◽  
William F Simonds
Keyword(s):  
Serum Calcium ◽  
Repeated Measures ◽  
Calcium Level ◽  
Ionized Calcium ◽  
Total Serum ◽  
P Value ◽  
Total Calcium ◽  
Total Serum Calcium ◽  
Parathyroid Disease ◽  
Calcium Status

Abstract Context: The serum calcium level is one of most routinely ordered tests in clinical practice. Many factors can affect calcium level and its interpretation. There are challenges and barriers in applying calcium correction formulas to every-day practice. Objective: Revisit correlation between total and ionized calcium levels, and dependence of serum calcium on albumin, pH and creatinine levels. Methods: This study included 1537 subjects enrolled in a parathyroid disease clinical protocol. We examined calcium and relevant biochemistry tests collected simultaneously and repetitively over consecutive years. Histograms, repeated measures correlation, correlation plots, and liner regression plots were used to analyze and visualize the data. Results: We found that: 1) directly measured total serum calcium and ionized calcium had excellent correlation and dependence with p-value=2.2e-16, repeated measures correlation coefficient (rmcorr)=0.919, and 95% interval (CI) = 0.916 to 0.922; 2) there was a low dependence between total serum calcium and albumin levels (rmcorr=0.454, 95% CI=0.433 to 0.474), a low dependence between ionized calcium and pH levels (rmcorr=-0.309, 95% CI= -0.326 to -0.292), and no dependence between total calcium and creatinine levels (rmcorr=0.026 95% CI=0.012 to 0.040); 3) using the commonly applied correction formulas, to either adjust total calcium based on albumin levels or else adjust ionized calcium based on pH levels, did not improve dependence among them. Conclusions: We therefore suggest using directly measured total serum calcium and/or ionized calcium level to assess clinical calcium status in general patients tested for parathyroid related disorders.

scholarly journals Correlation between QoTc and serum as well as ionised calcium in sick neonates

2020 ◽  
Vol 7 (5) ◽  
pp. 1033
Author(s):  
Yashoda H. T. ◽  
Kavya C. ◽  
Nithya E. ◽  
Laghna Gowda
Keyword(s):  
Serum Calcium ◽  
Calcium Level ◽  
Perinatal Asphyxia ◽  
Surrogate Marker ◽  
Ionized Calcium ◽  
Total Serum ◽  
Total Calcium ◽  
Serum Total Calcium ◽  
Total Serum Calcium ◽  
Total Serum Calcium Level

Background: Hypocalcemia is a frequently observed clinical and laboratory abnormality in neonates with risk factors such as prematurity, infant of diabetic mothers and perinatal asphyxia. Hypocalcemia can be asymptomatic or can cause apnoea, seizures, jitteriness, stridor, cardiac abnormalities. Clinically as calcium levels are maintained within narrow ranges. It is therefore imperative to measure and correct any deficit at the earliest. Unfortunately, total serum calcium level correlates poorly with ionized calcium level. Measurement of ionized calcium is both time consuming and expensive and therefore the need for more rapid, inexpensive and non-invasive method for screening at risk-neonates. Serum calcium levels are known to affect the duration of the QoTc interval. Therefore establishing a good correlation between serum/ionized calcium levels and QoTc will validate ECG as a reliable marker of hypocalcemia. Objective was to find correlation between QoTc interval and serum calcium levels in sick neonates.Methods: Total 730 infants were for serum total calcium and ionized calcium levels. Off these 142 infants with hypocalcemia, 29 infants were excluded based on exclusion criteria. The remaining 113 neonates were subjected to three cycles of ECG measurement before correction of calcium and were taken as cases. QoTc intervals were measured and were correlated with corresponding serum total calcium and ionized calcium levels.Results: In this study, a moderate negative or downhill correlation was found between total serum calcium QoT (r = -0.694 and p = <0.001) and QoTc (r = -0.680 and p = <0.001). The ionized calcium levels were found to have strong negative or downhill correlation with QoT (r = -0.837 and p = <0.001), QoTc (r = -0.819 and p = <0.001). All these correlations were found to be statistically significant with p<0.05.Conclusions: QoTc interval can be used as a surrogate marker for blood total or ionized calcium levels.

scholarly journals Is calcium a concern in neonates undergoing phototherapy?

2018 ◽  
Vol 5 (3) ◽  
pp. 988 ◽  
Author(s):  
N. L. Sridhar ◽  
Sreeram S. ◽  
Madoori Srinivas
Keyword(s):  
Serum Calcium ◽  
Calcium Concentration ◽  
Calcium Absorption ◽  
Newborn Infants ◽  
Late Preterm ◽  
Ionized Calcium ◽  
Preterm Neonates ◽  
Total Serum ◽  
Study Group ◽  
Total Serum Calcium

Background: Neonatal hypocalcemia is defined as total serum calcium concentration of < 7 mg/dl or ionized calcium concentration of <4 mg/dl (<1 mmol/L). The current aim was to look the effect of phototherapy on ionized calcium levels before and after phototherapy in otherwise healthy term and late preterm (35 to 37 weeks) neonates.Methods: The study group included 50 neonates. Measurement of serum ionized calcium levels was done before and at the end of phototherapy.Results: At the end of phototherapy in study group, a significant fall in calcium level in 64% of term and 76% of late preterm neonates was observed, but almost all except one remained asymptomatic.Conclusions: The efficacy of phototherapy in the prevention and treatment of hyperbilirubinemia in newborn infants has been well established. The mean duration of phototherapy in our study was 32 hours. Duration of phototherapy may influence the severity of hypocalcaemia. The regulation of calcium homeostasis in the newborn period has been of considerable interest. Phototherapy increases calcium absorption by the bones and leads to the reduction of melatonin levels. Changes in melatonin levels affect the incidence of hypocalcaemia-induced phototherapy. The mechanism of hypocalcaemia effect of phototherapy was reported by inhibition of pineal gland via transcranial illumination, resulting to decline of melatonin secretion; which blocks the effect of cortisol on bone calcium. It is suggested that serum calcium levels be assessed in neonates treated with phototherapy. Neonatal Jaundice is one of the most common problems that can occur in the newborn. Hypocalcaemia during phototherapy has been reported in literature.

Optimal Discrimination of Mild Hyperparathyroidism with Total Serum Calcium, Ionized Calcium and Parathyroid Hormone Measurements

1987 ◽  
Vol 92 (2) ◽  
pp. 147-176 ◽  
Author(s):  
Lars Benson ◽  
Sverker Ljunghall ◽  
Torgny Groth ◽  
Hans Falk ◽  
Andreas Hvarfner ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Serum Calcium ◽  
Ionized Calcium ◽  
Total Serum ◽  
Total Serum Calcium

scholarly journals To Study the Association of Total Serum Calcium Level in Assessing the Severity of Pancreatitis

2021 ◽  
pp. 781-785
Author(s):  
V. Lingesh Kumar ◽  
Saravanan Sundaram
Keyword(s):  
Acute Pancreatitis ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Tertiary Care ◽  
Total Serum ◽  
Total Calcium ◽  
Blood Calcium ◽  
Total Serum Calcium ◽  
Total Serum Calcium Level

Background: Pancreatitis is an inflammatory condition that affects the pancreas and may also affect other tissues or distant organ. In this study our aim is to see if blood calcium level can be used as a prognostic marker in determining the severity of acute pancreatitis because hypocalcaemia is linked to higher mortality and hospitalization. Method: A retrospective study was conducted in the medical records department of a tertiary care health facility. A total of 75 participants were included in the research. .demographic details of all patients were collected .Patients above 18 years who presented with of epigastric pain, pre-Diagnosed gallstones, alcoholism were included int this study. The lowest total calcium levels were collected in order to examine total calcium as a predictive factor for severity. All of these information were collected and analyzed to get the appropriate findings. Results: A total of 75 patients were included in the research. The age of patients in each severity grade did not differ significantly (p value>0.05). The gender distribution of the two groups did not differ. (P >0.05). For mild and severe acute pancreatitis, mean total calcium levels were 7.98 and 6.67, respectively, which was statistically significant (p< 0.05). Conclusion: The total serum calcium level is a useful indicator for assessing  pancreatitis.

scholarly journals The Role of Serum Calcium Levels in Pediatric Dyslipidemia: Are There Any?

2021 ◽  
Vol 9 ◽  
Author(s):  
Yaguang Peng ◽  
Lixin Hu ◽  
Xiaolu Nie ◽  
Siyu Cai ◽  
Ruohua Yan ◽  
...  
Keyword(s):  
Serum Calcium ◽  
Dose Response ◽  
Calcium Level ◽  
Pediatric Population ◽  
Reference Intervals ◽  
Total Serum ◽  
Response Analysis ◽  
Cross Sectional ◽  
Total Serum Calcium ◽  
Increased Risk

Background: No previous study explored the association between serum calcium levels and dyslipidemia in children. This study aimed to explore this relationship in children, based on a multicenter cross-sectional study population in China.Methods: Cross-sectional data was derived from the Pediatric Reference Intervals in China (PRINCE) study conducted between 2017 and 2018 involving 5,252 males and 5,427 females with a mean age of 10.0 ± 4.6 years. Multivariable logistic regression models were applied to calculate odds ratios (ORs), with 95% confidence intervals (CIs), for dyslipidemia of each serum calcium level and albumin-corrected calcium levels, which were sorted into quartiles. The restricted cubic spline model was fitted for the dose-response analysis. An L-shaped dose-response relation between calcium levels and the probability of dyslipidemia was found after the adjustment for multiple potential confounding factors, p for non-linear &lt; 0.001.Results: Using the middle category of calcium level as the reference, multivariable-adjusted ORs and 95% CIs of the lowest and the highest quartile categories were 0.96 (0.82–1.12) and 1.29 (1.12–1.48), respectively, for total serum calcium levels and 1.06 (0.91–1.23) and 1.39 (1.21–1.60) for albumin-corrected calcium levels.Conclusions: Individuals with higher levels of serum calcium were associated with increased risk of dyslipidemia in a sample of a healthy Chinese pediatric population. The association between serum calcium levels and dyslipidemia needs to be examined prospectively in future studies.

Sign in / Sign up

Export Citation Format

Share Document