Should ICU patients with hypocalcemia receive calcium supplementation?

Updated: Aug 08, 2019
  • Author: Manish Suneja, MD, FASN, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Hypocalcemia is found in over half the patients admitted to intensive care units (ICUs). [45, 33] Studies in critically ill patients have yielded conflicting results, with some suggesting that hypocalcemia is likely a marker of disease severity, and that calcium values usually normalize spontaneously with resolution of the primary disease process. [46, 33] Indeed it has been posited that low levels in critical illness may be protective and attempted correction may be harmful. [46]

In contrast, other studies have concluded that both moderate and mild hypocalcemia are associated with increased mortality, whereas mild hypercalcemia is associated with lower mortality. [45]   One large retrospective study found that calcium supplementation during the ICU stay improved 28-day survival in critically ill adult patients. [47]

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