Calcium, Magnesium and phosphate deficiency and their Effect on Clinical outcome in Critically Ill child
A.A.Abouamer1, D.R.Soliman1, H.M.Shaban2 and N.M.Anter 2"
Critical illness may trigger an acute phase response which is associated with several metabolic derangements. These include hypocalcaemia, hypophosphatemia and hypomagnesaemia. To determine the incidence and associated risk factors of hypocalcaemia, hypomagnesaemia and hypophosphatemia that develop in critically ill children and their effect on their clinical outcome. 50 child enrolled in our study aged from 1month to 6 years admitted in pediatric intensive care unit in Benha University Hospital. Levels of serum calcium, magnesium and phosphate were measured during admission. The following variables were analyzed: age, gender, diagnosis on admission, clinical severity score on admission OFI (Organ Failure Index) and daily scores PELOD (Pediatric Logistic Organ Dysfunction), length of hospital stay and outcome were analyzed. Out of 50 patients, the frequency of Calcium deficiency was (64%), magnesium deficiency (46%), and phosphate deficiency (57%) on admission. There was negative correlation between calcium level and PELOD (P=0.048), OFI (P=0.001) and period of hospitalization (P=0.002). Patients with hypomagnesaemia on admission had higher PELOD score (P=0.008), higher OFI (P=0.008),prolonged period of hospitalization(P=0.038) and was associated with hypokalemia (P<0.05).
Hypophosphatemia was associated with higher PELOD score (P=0.019) and increased period of hospitalization (P=0.012). Mortality rate increased in patients with hypocalcaemia (P=0.022) and also in patients with hypomagnesaemia (P=0.006). Deficiency of calcium, magnesium and phosphate were common among critically ill children and affected clinical outcome of patient.
Hypocalcemia, Hypomagnesemia, Hypophosphatemia, Critical illness, Clinical outcome.