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Chapter-41 Hypocalcemia

BOOK TITLE: IAP Textbook of Pediatric ICU Protocols

Author
1. Soans Santosh T
2. Nayak Prasad
ISBN
9789350903704
DOI
10.5005/jp/books/11878_41
Edition
2/e
Publishing Year
2013
Pages
4
Author Affiliations
1. AJ Institute of Medical Sciences, Mangalore, AJ Institute of Medical Sciences, Mangalore, Karnataka, India, Mangalore, Karnataka, AJ Institute of Medical Sciences, Mangaluru, Karnataka, India, AJ Medical College, Mangaluru, Karnataka, India, IAP—2018; AJ Institute of Medical Sciences and Research Centre, Mangaluru, Karnataka, India, Chief Neonatal and Pediatric intensive Care Division, AJ Institute of Medical Sciences and Research Centre, Mangaluru, Karnataka, President IAP 2018
2. AJ Institute of Medical Sciences, Mangalore, Karnataka, India
Chapter keywords
Hypocalcemia, Total serum calcium, Papilledema, Symptomatic hypocalcemia, Achlorhydria, Oral calcium

Abstract

Hypocalcemia is seen in nearly 15–50% pediatric ICU admissions. Hypocalcemia is when the total serum calcium is less than 8.5 mg/dl. Acute hypocalcemia causes life-threatening events especially through disordered neuromuscular and cardiovascular physiology. Other clinical manifestations of hypocalcemia include cataracts, papilledema, coarse skin and brittle nail. The chapter lists out the causes of hypocalcemia. Its approach and treatment are given in the form of flowcharts. Emergency treatment with intravenous calcium is indicated in severe, symptomatic hypocalcemia. Calcium infusions can be given for persistent hypocalcemia in children. In case of achlorhydria in the stomach, oral calcium at a dose 50 mg/kg/day of elemental calcium daily can be given.

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