Publication: Serum calcium concentrations and incidence of hypocalcemia in infants with moderate or severe hypoxic-ischemic encephalopathy: Effect of therapeutic hypothermia
Issued Date
2015-01-01
Resource Type
ISSN
18726232
03783782
03783782
Other identifier(s)
2-s2.0-84937847424
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Early Human Development. Vol.91, No.9 (2015), 535-540
Suggested Citation
Chatchay Prempunpong, Ionut Efanov, Guilherme Sant'Anna Serum calcium concentrations and incidence of hypocalcemia in infants with moderate or severe hypoxic-ischemic encephalopathy: Effect of therapeutic hypothermia. Early Human Development. Vol.91, No.9 (2015), 535-540. doi:10.1016/j.earlhumdev.2015.06.008 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/36787
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Serum calcium concentrations and incidence of hypocalcemia in infants with moderate or severe hypoxic-ischemic encephalopathy: Effect of therapeutic hypothermia
Other Contributor(s)
Abstract
© 2015 Elsevier Ireland Ltd. Background: Hypocalcemia is a common morbidity in asphyxiated infants. Therapeutic hypothermia (TH), the standard of care for infants with moderate and severe hypoxic-ischemic encephalopathy (HIE), promotes neuroprotection by several mechanisms including a decrease in intracellular calcium (Ca<sup>2+</sup>) influx which may improve serum Ca<sup>2+</sup> levels and homeostasis. Aims: To evaluate the impact of TH on Ca<sup>2+</sup> homeostasis. Study design: Historical, retrospective cohort analysis. Subjects: Infants with moderate or severe HIE admitted to the hospital with. ≤. 24. hours of age, gestational age. ≥36weeks, and birth weight ≥1800g, before (pre-TH) and after (post-TH) TH was implemented. Outcome measures: Minimum and maximum serum levels of ionized Ca<sup>2+</sup> (iCa<sup>2+</sup>) and magnesium (Mg), Ca<sup>2+</sup> and Mg intakes, and incidence of hypo/hypercalcemia during the first week of life. Results: A total of 67 infants were included: 29 pre-TH and 38 post-TH. Minimum iCa<sup>2+</sup>levels were significantly lower in the pre-TH group; some infants required Ca<sup>2+</sup> boluses infusions. In the post-TH group, a significantly lower intake of Ca<sup>2+</sup> was necessary to maintain normal Ca<sup>2+</sup> levels and no infant required boluses. The incidence of hypocalcemia was higher in the pre-TH group with a statistically significant difference on day 2 of life (18 vs 0%; p=0.01). Conclusions: After the implementation of TH, iCa<sup>2+</sup> levels were within normal ranges despite lower Ca<sup>2+</sup> intakes. A lower incidence of hypocalcemia was observed during cooling. Our findings support the hypothesis that TH improves Ca<sup>2+</sup> homeostasis in HIE infants.