Correction of hypocalcaemia in the critically ill: What is the haemodynamic benefit?

Abstract

The prevalence of hypocalcaemia is known to be elevated in critically ill patients, but the expected benefit from calcium repletion in hypocalcaemic patients has not been well defined. The objective of the present study was therefore prospective determination of the cardiovascular response to calcium administration in critically ill patients with hypocalcaemia. A total of 17 patients found to have ionized hypocalcaemia (Ca²⁺P2 and from 2133±647 to 2378±817 dynes·s·cm⁻⁵m⁻², respectively). Left ventricular stroke work index increased from 23±8 to 32±13 g·m/m² (P<0.01). These changes were maintained for 60 min. The correction of hypocalcaemia can result in a significant increase in arterial pressure that can persist for at least 1 h. Despite an associated improvement in left ventricular function, cardiac index and oxygen delivery do not increase significantly.